INCIDENCE OF CAROTID STENOSIS WITH MULTIPLE CORONARY ARTERY DISEASE IN ISCHEMIC STROKE PATIENTS AMONG EGYPTIAN POPULATION

Background: An association between carotid atherosclerosis and coronary artery disease (CAD) has been well established as atherosclerosis is considered to be a generalized disease. Furthermore, many imaging modalities are used to assess cerebral vascular abnormalities. Objective: To assess carotid and coronary stenosis association, along with imaging modalities to diagnose carotid stenosis. Patients and Methods: A prospective cohort study was conducted between November 2019 to February 2021 in Al-Hussein University Hospital, Al-Maadi Military Hospital and Misr El-Qadema Mabara Hospital with 120 patients divided in two equal groups; the first group was patients who have cerebrovascular stroke, and the second group was patients who have multiple coronary artery diseases. Carotid and coronary stenosis were assessed in each group. All patients had been investigated with CT angiography and carotid duplex. Results: The prevalence of coronary artery diseases among patients with carotid stenosis was 26.6% with 16 patients from 60 patients. On the other hand, the prevalence of carotid artery stenosis among patients with coronary artery diseases was 31.6% with 19 patients from 60 patients. Subsequently, There is a significant positive correlation between coronary and carotid stenosis with (r= 0.886; CI 95% = 0.813-0.932; P < 0.001). CT angiography was more sensitive than carotid duplex but, on the other hand, carotid duplex was more specific in detecting carotid stenosis. Conclusion: There was a significant association between coronary artery stenosis and carotid vascular abnormalities. Additionally, digital subtraction angiography remains the gold standard imaging modality in detecting carotid stenosis.