Carotid Plaque May Predict Coronary Artery Stenosis

Increased artery plaque is associated with greater likelihood of coronary disease.
Increased artery plaque is associated with greater likelihood of coronary disease.

VANCOUVER, BC—Maximal carotid artery plaque height (MCAH) may predict coronary artery stenosis in patients with and without chronic kidney disease (CKD), researchers reported at the Canadian Society of Nephrology annual meeting.

“Carotid ultrasound with plaque quantification may aid the selection of patients who would benefit from coronary angiography, and results appear to be generalizable to the CKD population,” the authors concluded in a study abstract.

The researchers, led by Jocelyn Garland, MD, of Queen's University in Kingston, Ont., noted that coronary angiography, which is used to diagnose occlusive coronary disease, can be nephrotoxic. MCAH quantification is an emerging surrogate for coronary intimal atherosclerosis and has been correlated with coronary events in the general population, they stated.

Dr. Garland's group studied 266 outpatients referred for coronary angiography and had data available for estimating kidney function. MCAH and carotid intimal media thickness (CIMT) were measured using carotid ultrasound. Coronary artery disease was defined as at least 1 coronary artery with greater than 50% stenosis demonstrated by angiography.

Patients who had coronary stenoses had significantly increased MCAH compared with patients who did not (2.64 mm vs. 1.81 mm). CIMT was not significantly different between the groups.

In multivariable analysis, increased MCAH was associated with a 3-fold increased likelihood of coronary artery stenosis greater than 50%. In patients with CKD (estimated glomerular filtration rate below 60 mL/min/1.73 m2), it was associated with a significant 4.5 times increased likelihood.

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