西野 雅巳, 伊東 達夫, 石田 麻里子, 加藤 順司, 江角 章, 舛形 尚, 大西 修作, 棚橋 秀生, 末吉 建治, 安野 雅夫, 山田 義夫

Masami NISHINO, Tatsuo ITO, Mariko ISHIDA, Junji KATO, Akira EZUMI, Hisashi MASUGATA, Shusaku OHNISHI, Hideo TANAHASHI, Kenji SUEYOSHI, Masao YASUNO, Yoshio YAMADA

大阪労災病院内科

Department of Internal Medicine, Osaka Rosai Hospital

キーワード : Carotid ultrasonography, Ischemic heart disease, Atheroscl erosis

In this study we examined the relationship between coronary atherosclerosis, carotid atherosclerosis and cerebral atherosclerosis in 86 men and 43 women who underwent coronary angiography for chest pain or suspected coronary artery disease. B-mode carotid ultrasonography, brain computed tomography and plasma assays of lipoproteins were examined simultaneously.
We found that patients with severe coronary artery disease tended to have carotid artery disease and silent cerebral infarction more frequently than did those without. A low plasma HDL-cholesterol level was associated with an increased risk of coronary artery disease, carotid artery disease and silent cerebral infarction. Furthermore, a positive relationship between the atherosclerotic index and coronary atherosclerosis was most notable (p<0.005) in cases of atherosclerosis (carotid atherosclerosis: p< 0.05, cerebral atherosclerosis: n. s.). Finally, carotid ultrasonography was useful in predicting silent cerebral infarction in cases of ischemic heart disease. In younger people (less than 60 years old) of 2 and 3 vessel disease, the posotive predictive value was 71.4% and the negative predictive value was 85.7%.