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. 2016 Sep;46(5):639-645.
doi: 10.4070/kcj.2016.46.5.639. Epub 2016 Sep 28.

Association between the Gensini Score and Carotid Artery Stenosis

Affiliations

Association between the Gensini Score and Carotid Artery Stenosis

Anil Avci et al. Korean Circ J. 2016 Sep.

Abstract

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.

Keywords: Carotid artery disease; Coronary atherosclerosis; Doppler ultrasonography.

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Conflict of interest statement

The authors have no financial conflicts of interest.

Figures

Fig. 1
Fig. 1. Comparison of the Gensini score and the SYNTAX score between the groups according to the severity of carotid artery stenosis.
Fig. 2
Fig. 2. Distribution of the patients with various severity of CAS between the tertiles of Gensini score. CAS: carotid artery stenosis.
Fig. 3
Fig. 3. Receiver operating characteristic curve of the Gensini score for predicting significant CAS in patients undergoing CABG. CAS: carotid artery stenosis, CABG: coronary artery bypass grafting, AUC: area under the curve.

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