Carotid and femoral atherosclerotic lesions in patients with coronary heart disease confirmed by angiography.

INTRODUCTION: Clinically evident atherosclerosis is preceded by preclinical changes in the arterial wall. These changes are characterised by increased thickness of the intima-media complex (IMT).

AIMS: A complex ultrasound assessment of the peripheral vessels as well as an attempt to find ultrasound parameters correlating with the burden of atherosclerotic lesions of the coronary arteries.

METHODS: 231 patients who underwent both coronary angiography and ultrasound examination of the following arteries: common carotid artery (CCA), carotid bulb and common femoral artery (CFA) were enrolled. The IMT value, presence of plaque and Doppler blood flow parameters were evaluated. Selected clinical and biochemical risk factors of atherosclerosis were assessed. Two groups of patients were analysed: 200 patients with coronary artery disease confirmed by angiography (study group), and 31 patients with normal coronary arteries (control group).

RESULTS: Significantly higher values of the IMT in the peripheral arteries were observed in patients with coronary artery lesions than in those without (CCA - 0.91 vs 0.61 mm, carotid bulb -- 1.31 vs 0.67 mm, CFA -- 1.38 vs 0.63 respectively, p<0.0001). Atherosclerotic plaques were present only in patients with coronary artery disease. Additionally, IMT values of the CCA, carotid bulb and CFA were significantly higher in patients with severe coronary artery disease (three vessel disease) than in patients with lesions in one or two coronary arteries.

CONCLUSIONS: Patients with coronary lesions present with increased IMT values and higher plaque occurrence. Complex ultrasound evaluation of different peripheral arteries (CCA, carotid bulb and CFA) may be used as part of the cardiovascular risk stratification.