Carotid total plaque area as an independent predictor of polyvascular disease in patients with stable coronary artery disease

Abstract

Aim. To study the prognostic value of the carotid total plaque area (cTPA) in relation to the presence of multivessel coronary artery disease in patients with stable coronary artery disease (CAD).
Methods. The study included 86 patients with stable CAD. All patients underwent a duplex scan of the arteries of the carotid and lower limb arteries, invasive coronary angiography (CA). In the longitudinal position, allowing to achieve the best visualization of atherosclerotic plaque, the area of plaque was measured in the manual tracing mode. These measurements were performed for each visualized plaque, with subsequent calculation of the total indicator (cTPA).
Results. Obstructive coronary atherosclerosis was diagnosed in 79.0% of cases, while three-vessel disease was observed in 40.7% of patients. An increase in cTPA ≥ 44.0 mm2 made it possible to predict the presence of a three-vessel disease with a sensitivity of 66.7% and a specificity of 75.5%. The choice of a threshold value of cTPA ≥55.0 mm2 made it possible to increase specificity to 87.8% at the cost of reducing sensitivity to 51.5%. An increase in cTPA ≥55.0 mm2 was associated with a odds ratio of a three-vessel disease of 4.86 (95% confidence interval (CI) 1.17–20.2; p = 0.029). According to linear regression, an increase in cTPA of 6.84 mm2 was associated with an increase in the SYNTAX score of 1 unit.
Conclusion. In patients with stable CAD, the carotid total plaque area directly correlates with the severity of coronary atherosclerosis. An increase in cTPA ≥55.0 mm2 made it possible to predict the presence of a three-vessel disease with a sensitivity of 51.5% and a specificity of 87