• Ming-Jer Hsieh, Chun-Chi Chen, Tsong-Hai Lee, Cheng-Hung Lee, Ming-Shien Wen, Fun-Chung Lin, I-Chang Hsieh, and Delon Wu.
• Department of Internal Medicine, Second Section of Cardiology, Chang Gung Memorial Hospital, Linkou Medical Center, Chang Gung University College of Medicine, Taoyuan, Taiwan.
• Am. J. Med. Sci. 2009 Dec 1; 338 (6): 447-52.

BackgroundCoronary artery disease (CAD) is the most important cause of mortality and morbidity in patients who have undergone carotid artery endovascular or surgical intervention. Metabolic syndrome (MetS) and hyperhomocysteinemia (HHCY) have been reported to be associated with CAD. However, no study has investigated the association between MetS or HHCY and the severity of CAD in patients with carotid stenosis.MethodsTotal of 148 consecutive patients with at least 1 side of the extracranial internal carotid artery were enrolled. Further, on the basis of the results of coronary angiography, the patients were divided into the CAD group (n = 85) and the non-CAD group (n = 63).ResultsMultiple regression analysis revealed that CAD was independently associated with HHCY (odds ratio: 4.07; 95% confidence interval: 1.93-8.57; P < 0.0001) and MetS (odds ratio: 3.38; 95% confidence interval: 1.56-7.29; P = 0.002). Furthermore, multivariate stepwise linear regression revealed that the MetS score and total plasma homocysteine level were significantly correlated with affected vessel number in CAD and the extent of coronary atherosclerosis.ConclusionsMetS and HHCY can predict the presence of CAD in patients with carotid stenosis. Furthermore, the MetS score and total plasma homocysteine level are significantly associated with the extent of coronary atherosclerosis.

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