Índice tornozelo-braquial e ultrassonografia de carótidas como marcadores diagnósticos de doença arterial coronariana

Abstract

Cardiovascular diseases represent the foremost cause of death among chronic and non-transmissible diseases. Atherosclerosis can also affect other arterial beds, mainly, carotids and peripheral arteries. Diagnostic tools commonly used for peripheral and carotid Atherosclerosis, such as Ankle-Brachial Index (ABI) and Carotid Ultrasonography, may contribute as surrogates for the diagnosis of Coronary Arterial Disease (CAD). We report a cross-sectional study of 50 patients referred to elective invasive coronary angiography (ICA). Patients were submitted to ABI and Carotid Ultrasonography - for Carotid Intimal-Media Thickness (IMT) and Carotid Atherosclerotic Plaque Screening (CAPS). Clinical and demographic variables were also evaluated. CAD was defined as greater than 50% stenosis in at least one epicardial artery. Amidst the clinical variables, “smoking” (p-value 0,001) and “dyslipidemia” (p-value 0,036) were statistically different between the groups. Under logistic regression analysis, only CAPS showed a statistically significant Area Under the Curve (AUC) for CAD prediction: 0,812. ABI and CIMT didn’t show statistically significant performance. For multivariate logistic regression analysis, the predictive capacity was better for the model including variables “gender”, “dyslipidemia”, “smoking”, “pack-years” and CAPS. The AUC for this model was 0,912. The screening for carotid atherosclerotic plaques may enhance traditional risk stratification strategies for CAD. Further studies and bigger samples of subjects are needed to allow extrapolation of our findings.