Integrated non-invasive approach to atherosclerosis with cardiac CT and carotid ultrasound in patients with suspected coronary artery disease

Objective: The aim of the study was to compare the atherosclerotic disease in the coronary and carotid arteries in patients who underwent non-invasive imaging for suspected stable coronary artery disease (CAD). Materials and methods: 107 patients (64 men, age 59 ± 12) with atypical chest pain underwent cardiac CT (CCT) and carotid ultrasound (US) on the same day. Severity (obstructive or not-obstructive disease), location, shape, and composition of atherosclerotic plaques in the two districts were evaluated. Results: Patients presented normal coronary arteries in 36 % (n = 38), not-obstructive CAD in 36 % (n = 39), and obstructive CAD in 28 % (n = 30), while had normal carotid arteries in 53 % (n = 57), not-obstructive disease in 44 % (n = 47), and obstructive disease in 3 % (n = 3) (p < 0.05). The coronary plaques were located in 7 % at ostial sites, in 29 % at non-ostial sites, and in 64 % at both locations. The carotid plaques were located at the origin of the internal and external carotid arteries in 56 %, at the bifurcation in 20 %, and at both locations in 24 % (p < 0.05). Coronary plaques were calcified in 25 %, non-calcified in 19 %, and mixed in 56 %; carotid plaques were calcified in 8 %, non-calcified in 8 %, and mixed in 84 % of patients (p < 0.05). Conclusion: Atherosclerotic disease presents different imaging findings in the coronary tree and in the carotid district with respect to lesion severity, position along the vessel course, and composition of plaque.