Prevalence and Risk Factors Analysis of Carotid Stenosis Among Ischaemic Heart Diseases Patient in Bangladesh: A Cross-Sectional Study

Redoy Ranjan,1,2 Dipannita Adhikary,2 Debasish Das,3 Asit Baran Adhikary1 1Department of Cardiac Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh; 2Department of Medicine & Veterinary Medicine, The University of Edinburgh, Edinburgh, UK; 3Department of Thoracic Surgery, Dhaka Medical College & Hospital, Dhaka, BangladeshCorrespondence: Redoy Ranjan, Department of cardiac Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, 1000, Bangladesh, Tel +8801717556046, Email redoy_ranjan@bsmmu.edu.bdPurpose: This study aimed to evaluate the prevalence of carotid stenosis among ischaemic heart disease (IHD) patients undergoing coronary artery bypass graft (CABG) surgery and identify risk factors associated with carotid stenosis at a tertiary-level hospital in Bangladesh.Patients and Methods: This cross-sectional study examined 200 IHD patients scheduled for isolated and elective CABG surgery, and multivariate regression analysis was used to determine the impact of independent variables on carotid stenosis with coronary artery disease. A vascular surgeon and sonographer assessed carotid stenosis, and the severity of stenosis was classified according to the current Grayscale and Doppler US diagnosis models.Results: We observed that the prevalence of carotid artery stenosis was 13.5%, and the male was significantly higher (85.2%) in the carotid stenosis group. A multivariate regression analysis observed that age (OR 1.79), dyslipidaemia (OR 2.19), uncontrolled hypertension (OR 2.38), uncontrolled DM (OR 2.51), multivessel coronary artery disease (OR 3.79), and multiple comorbidities (OR 4.46) are potential predictors of having significant carotid stenosis in a patient undergoing CABG surgery.Conclusion: In Bangladesh, multivessel coronary artery disease, especially in elderly patients with multiple comorbidities, are 4 (four) times higher risk to have significant carotid artery stenosis. Preoperative carotid duplex screening should be performed to curtail the risk of postoperative adverse cerebrovascular events, particularly those who have carotid stenosis associated potential risk factors.Keywords: prevalence, carotid stenosis, coronary artery disease, ischaemic heart disease