CAROTID ARTERY DUPLEX SCAN IN DIAGNOSING CORONARY ATHEROSCLEROSIS AND ASSESSING ITS SEVERITY

Aim. To assess the role of carotid artery duplex scan in diagnosing coronary atherosclerosis of varied severity.

Material and methods. The study included 194 patients (126 men and 68 women) aged 33-85 years who were hospitalised to the State Research Centre for Preventive Medicine and underwent coronary artery angiography and carotid artery duplex scan. The severity of coronary atherosclerosis at coronary artery angiography was assessed by the Gensini score.

Results. The combination of carotid and coronary artery atherosclerosis was observed in 74,7% of the patients. Among those with carotid atherosclerosis, coronary atherosclerosis was registered in 92,4%. This suggests that carotid artery duplex scan is highly sensitive in diagnosing coronary atherosclerosis, despite its low specificity (27,0% patients without carotid atherosclerosis had coronary atherosclerosis). Positive predictive value (likelihood of disease in those with positive test results) of carotid artery duplex scan was 84%. Patients with carotid atherosclerotic plaques had significantly higher Gensini scores than patients with atherosclerosis-free carotid arteries (32 vs. 3,5, respectively; p=0,012), which suggests more severe coronary atherosclerosis in the presence of carotid atherosclerotic plaques. The intima-media thickness values over 0,9 mm were associated with higher Gensini scores (11 vs. 32,5, respectively; p=0,003), confirming more severe coronary atherosclerosis in these patients. Participants with severe coronary atherosclerosis had 3 or more carotid atherosclerotic plaques (p<0,01), typically of heterogeneous structure (p=0,03). The highest Gensini scores were observed in patients with atherosclerotic plaques in common carotid arteries. Conclusion. The results obtained suggest that carotid artery duplex scan is highly informative in diagnosing coronary atherosclerosis and assessing its severity.

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