Prevalence of Extracranial Carotid and Vertebral Artrty Disease in Chinese Patients with Coronary Artery Disease

Abstract

OBJECTIVE: While it has been documented that extracranial cerebrovascular disease (ECCVD) is associated with coronary artery disease (CAD) in Caucasians, data associating ECCVD with CAD in Chinese patients is not available. Previous studies have reported that Chinese have an extremely low prevalence of carotid and vertebral artery disease in comparison with Caucasians. However, such studies have been limited to general hospital stroke admission or post-mortem series and were prone to selection bias. This study attempts to determine the prevalence of ECCVD in Chinese patients with CAD and to identify some of the associated risk factors. METHODS: We studied 153 consecutive Chinese patients with angiographically documented CAD. Duplex ultrasonography was performed to identify any underlying extracranial carotid and vertebral artery disease. Patient demographics, vascular risk factors, history of myocardial infarction, transient ischemic attack (TIA) or stroke, concomitant peripheral vascular disease (PVD), degree of left ventricular dysfunction, extent and severity of CAD were also noted and analysed. RESULTS: Significant (t 50%) stenosis of one or more of the extracranial cerebral arteries was found in 32 patients (21%). The internal and external carotid arteries were involved in 17/153 (11%) and 19/153 (12%) of the patients respectively. The vertebral artery was involved in 9/153 (6%) while the common carotid artery was involved in 3/153 (2%) of the patients. Diabetes mellitus, hypertension, a history of TL4 or stroke, and PVD were significantly associated with the presence of ECCVD. CONCLUSIONS: Significant ECCVD is not uncommon in Chinese patients with CAD and the prevalence is comparable to that reported in Caucasian population. Patients with a history of diabetes, hypertension, stroke, and PVD are more likely to have concomitant ECCVD.