Prevalence of atherosclerotic stenosis of carotid and cerebral arteries in patients with stable or unstable coronary artery disease

INTRODUCTION: Carotid arteries atherosclerosis is the recognized predictor of cardiovascular events. The coexistence of coronary atherosclerosis with cerebrovascular disease is associated with unfavorable clinical outcomes. OBJECTIVES: The aim of this study was to determine the prevalence of hemodynamically and clinically significant carotid and / or cerebral arteries stenosis in patients with stable and unstable coronary artery disease (CAD). PATIENTS AND METHODS: Cardiological and neurological examinations together with coronary angiography and carotid ultrasound were performed in 241 patients, transcranial Doppler imaging of cerebral arteries in 114 subjects. The prevalence of hemodynamically significant internal carotid artery (ICA) stenosis, intracranial artery stenosis and clinical signs of central nervous system (CNS) ischemia were compared between the patients with stable and unstable CAD. RESULTS: There was no significant difference in the prevalence of ICA stenosis (15.3 vs 19%) and in the prevalence of intracranial artery stenosis  (18 vs 16%) between  patients with stable and unstable CAD. The risk factors for cerebral arteries stenosis were: ICA stenosis [odds ratio, (OR) 13.21, 95% confidence intervals (CI): 5.93 - 41.89) and advanced CAD (OR 2.38, 95% CI: 1.13 - 4.09). Risk factors for CNS ischemic events were: ICA stenosis (OR 1.74, 95% CI: 1.01 - 3.16) and intracranial artery stenosis (OR 3.01, 95% CI: 1.66 - 5.57). CONCLUSIONS: The differences between the prevalence of atherosclerosis of the carotid and cerebral arteries between patients with stable and unstable CAD were not found in this study. Advanced CAD is one of the risk factors for hemodynamically significant cerebral arteries stenosis.