Silent carotid atherosclerosis in patients with coronary disease

Background: B-mode ultrasonography is a simple and valid method to evaluate subclinical atherosclerosis of the major superficial arteries. The aim of this study was to know by this technique the prevalence of carotid atherosc lerosis in patients with patients with coronary disease and related factors . Patients and Methods: In 232 patients (205 men and 27 women; age; mean [sta ndard deviation] 59 [8] years) with coronary disease, intima-media thicknes s (IMT). presence and number of atheroma plaques in carotid arteries were e valuated by B-mode ultrasonography. Controls were 50 healthy subjects whose age was not different from patients. Carotid atherosclerosis was considere d when IMT was higher than mean plus two standard deviations of control val ues, and/or existence of atheroma plaques. Results: Carotid IMT was increased in patients compared to controls 0.82 [0 .22] vs 0.62 [0.12] mm; p < 0.001) and there were more patients with plaque s (67 vs 20%; p < 0.001). Carotid atherosclerosis was found in 170 patients and 11 controls (73 vs 22%; p < 0.001). By multivariate analysis, carotid atherosclerosis was associated with age (odds ratio: 1.05; 95% confidence i nterval [CI]. 1.01-1.09) and smoking (odds ratio. 2.11; 95% CI: 1.04-4.26). The presence of more than one plaque was associated with levels of low-den sity-lipoprotein (LDL)-cholesterol (odds ratio, 1.01; 95% CI, 1.00-1.02). Conclusions: In the patients with coronary disease, prevalence of subclinic al carotid atherosclerosis is very high (73%), and it is associated with ag e and smoking. The advanced stage of atherosclerosis, evaluated by the exis tence of more than one plaque, is correlated with LDL-cholesterol levels.