Newly diagnosed carotid atherosclerosis in patients with coronary artery disease admitted for cardiac rehabilitation.

BACKGROUND: The association of coronary artery disease (CAD) with carotid artery disease has been well documented. However, data focusing on CAD patients participating in cardiac rehabilitation programs are lacking. We studied the prevalence of newly diagnosed carotid artery disease in CAD patients admitted for cardiac rehabilitation. METHODS: We performed carotid ultrasonography in 168 angiographically confirmed CAD patients admitted to two facilities. Patients with previous cerebrovascular episodes or carotid imaging were excluded. RESULTS: Out of 168 patients considered (mean age 65 +/- 8 years; males 76%; chronic stable angina as the reason for cardiac rehabilitation 34%, silent ischemia 14%, and acute coronary syndrome 52%), 149 (89%) were found to have carotid atherosclerosis. Carotid atherosclerosis was present in 83, 87, 89, and 93% of patients with one-, two- and three-vessel disease and left main stem CAD respectively. Patients with severe CAD (i.e. three-vessel or left main stem) had a higher prevalence of > or = 50% carotid stenosis as compared to patients without severe CAD (26 vs 8%, p or = 50% carotid stenosis. CONCLUSIONS: Silent and previously undetected carotid atherosclerosis is frequent in CAD patients admitted for cardiac rehabilitation. The absence of severe CAD reflects the absence of > or = 50% carotid stenosis.