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KMID : 0368120160460050639
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Korean Circulation Journal
2016 Volume.46 No. 5 p.639 ~ p.645
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Association between the Gensini Score and Carotid Artery Stenosis
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Avci Anil
Fidan Serdar
Tabakci Mehmet Mustafa
Toprak Cuneyt
Alizade Elnur
Acar Emrah
Bayam Emrah
Tellice Muhammet
Naser Abdurrahman
Kargin Ramazan
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Abstract
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Background and Objectives: The aim of this study was to evaluate the association between the extent of coronary artery disease assessed by the Gensini score and/or the SYNTAX score and the significant carotid stenosis in patients undergoing coronary artery bypass grafting (CABG).
Subjects and Methods: A total of 225 patients who had carotid doppler ultrasonography prior to CABG were included retrospectively. Significant coronary artery disease was assumed as a lumen diameter stenosis of ≥50% in any of the major epicardial coronary arteries. The severity of carotid stenosis was determined by B-mode and duplex ultrasonography. Clinically significant carotid stenosis was defined as peak systolic velocity greater than 125 cm/s.
Results: The mean value of SYNTAX score and Gensini score was highest in patients allocated to significant carotid stenosis (22.98±7.32, p<0.001 and 77.40±32.35, p<0.001, respectively). The other risk factors for significant carotid stenosis were found to be male gender (p=0.029), carotid bruit (p<0.001), diabetes (p=0.021), left main disease (p=0.002), 3-vessel disease (p=0.008), chronic total coronary occlusion (p=0.001), and coronary artery calcification (p=0.001) in univariate analysis. However, only the Gensini score (odds ratio[OR]=1.030, p=0.004), carotid bruit (OR=0.068, p<0.001), and male gender (OR=0.190, p=0.003) were the independent predictors. The Gensini score cut off value predicting significant carotid stenosis was 50.5 with 77% sensitivity (p<0.001).
Conclusion: The Gensini score may be used to identify patients at high risk for significant carotid stenosis prior to CABG.
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KEYWORD
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Coronary atherosclerosis, Carotid artery disease, Doppler ultrasonography
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