CAN PRESENCE OF AORTIC PLAQUE PREDICT CORONARY HEART DISEASE?



Takanobu Tomaru, M.D., Toho University Medical School, Tokyo, Japan

Carotid arteriosclerosis has been shown to be associated with coronary artery disease(CAD), however, the association does not seem to be very close. On the other hand, presence of aortic plaque (AP) may be associated with generalized arteriosclerosis because arteriosclerosis has been shown to originate from lower aorta. Carotid sclerosis was diagnosed by carotid ultrasonography(US). Aortic plaque was evaluated by US and CT(grading), and aortic valve calcification(AVC) was evaluated by echocardiography. Aortic Calcification was evaluated by CT. Aortic stiffness was calculated by cardio-ankle vascular index(CAVI). In 74 patients with aortic plaque (P patient), 46 patients had CAD (62.1%), 6 had PAD and 10 had CI. In 62 patients without plaque (NP patient), only 6 (9.68%) had CAD,2 had CI and none had PAD. Incidence of CAD was higher in P patients than that in NP patients(P<0.01). In patients with aortic calcification by CT, CAD was observed in only 16.3%. Aortic plaque grade by CT was associated with presence of CAD(P<0.005). Mean PS in P patients was higher than that in NP patients P<0.0001). Carotid plaque was not present in 3 of plaque group and in 19 of no plaque group(P<0.05). AVC or AP was an independent predictor of CAD. Presence of both aortic and carotid plaque with aortic valve sclerosis could strongly suggest presence of CAD (sensitivity or specificity> 95%).