Carotid Artery Doppler Study in Patients Presenting with STEMI

Carotid Artery Doppler Study with STEMI

Authors

  • Owais Khan Department of Cardiology, Medical Teaching Institute-Hayatabad Medical Complex, Peshawar, Pakistan
  • Tashfeen Irtaza Khan Department of Cardiology, Medical Teaching Institute-Hayatabad Medical Complex, Peshawar, Pakistan
  • Cheragh Hussain Department of Cardiology, Medical Teaching Institute-Hayatabad Medical Complex, Peshawar, Pakistan
  • Yamna Ali Department of Cardiology, Medical Teaching Institute-Hayatabad Medical Complex, Peshawar, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v6i12.3534

Keywords:

Carotid Artery Disease, ST-Elevation Myocardial Infarction, Doppler Ultrasound, Carotid Stenosis, Hypertension

Abstract

Carotid Artery Disease (Carotid CAD) is a significant risk factor for cardiovascular events, particularly in patients with ST-Elevation Myocardial Infarction (STEMI). Carotid artery stenosis (CAS) has been related to poor outcomes in STEMI patients, but limited data exist on the prevalence and severity of CAS in this population, especially in Pakistan. Objectives: To evaluate the presence, severity, and characteristics of Carotid CAD through Doppler ultrasonography in STEMI patients, and to assess the relationship between CAS and clinical outcomes such as hospital stay duration. Methods: A cross-sectional observational study was conducted at Hayatabad Medical Complex, Peshawar, from May 2025 to August 2025. A total of 172 patients with STEMI were assessed using a Mindray® DC 70 Colour Doppler Ultrasound Scanner. The severity of CAS was classified as mild, moderate, or severe based on Peak Systolic Velocity (PSV). Results: The study found that 48 (27.9%) patients had mild CAS, 86 (50%) had moderate stenosis, and 38 (22.1%) had severe stenosis. The mean PSV values were 95.3 cm/s (mild), 123.4 cm/s (moderate), and 142.8 cm/s (severe). Patients with severe stenosis had significantly longer hospital stays (mean 9.2 days) compared to mild (6.3 days) and moderate stenosis (7.5 days); the p-values obtained were 0.025 and 0.035, respectively. Hypertension showed a significant association with severe stenosis (p = 0.016). Conclusions: This research work highlights the high prevalence of CAD in STEMI individuals.

References

Rafailidis V, Chryssogonidis I, Xerras C, Nikolaou I, Tegos T, Kouskouras K et al. A Comparative Study of Color Doppler Imaging and Contrast-Enhanced Ultrasound for the Detection of Ulceration in Patients with Carotid Atherosclerotic Disease. European Radiology. 2019 Apr; 29(4): 2137-45. doi: 10.1007/s00330-018-5773-8.

Pérez IS, Martínez-Valle F, del Castillo AG, Orozco-Galvez O, Callejas-Moraga EL, Fonollosa-Pla V et al. Fri0343 Evaluation of Carotid Hemodynamic Parameters and Plaques by Doppler Ultrasound in Patients with Systemic Sclerosis. Annals of the Rheumatic Diseases. 2019 Jun; 78: 853. doi: 10.1136/annrheumdis-2019-eular.4789.

Aasim M, Mustafa H, Aziz R, Hussain S, Khan MS. Doppler Ultrasound Screening for Significant Carotid Artery Stenosis in Cardiac Surgery Patients, Presenting to Hayatabad Medical Complex, Peshawar, Pakistan. 2020 Apr. doi: 10.21203/rs.3.rs-21717/v1.

Rehana K, Shuaib I, Khan J, Gul H, Khattak N, Nawab K. Validity of Carotid Doppler Ultrasound for Detection of Carotid Artery Plaque Keeping Computed Tomography Sensitivity as Reference Standard. Pakistan Journal of Medical and Health Sciences. 2022 Oct; 16(07): 971-. doi: 10.53350/pjmhs22167971.

Steinvil A, Sadeh B, Arbel Y, Justo D, Belei A, Borenstein N et al. Prevalence and Predictors of Concomitant Carotid and Coronary Artery Atherosclerotic Disease. Journal of the American College of Cardiology. 2011 Feb; 57(7): 779-83. doi: 10.1016/j.jacc.2010.09.047.

Iqbal S, Bhatti SM, Butt MU, Jamil F, Habib F, Kainat R. Carotid Artery Disease in Anterior Circulation Strokes: A Retrospective Analysis using Doppler Ultrasound. Pakistan Journal of Medical & Health Sciences. 2022 Apr; 16(02): 1104-. doi: 10.53350/pjmhs221621104.

Tanveer R, Khan A, Nasreen A. Role of Carotid Doppler Ultrasound in Detecting the Carotid Artery Disease Resulting in Stroke After CABG Surgery. Pakistan Heart Journal. 2018; 51(3).

Karn AK, Narayan S, Qavi A, Maurya PK, Singh A, Kulshreshtha D. Sequential Carotid Doppler Study in Acute Stroke and Its Clinical Correlation: A Prospective Study. Journal of Neurosciences in Rural Practice. 2024 Feb; 15(1): 42. doi: 10.25259/JNRP_342_2023.

Birmpili P, Porter L, Shaikh U, Torella F. Comparison of Measurement and Grading of Carotid Stenosis with Computed Tomography Angiography and Doppler Ultrasound. Annals of Vascular Surgery. 2018 Aug; 51: 217-24. doi: 10.1016/j.avsg.2018.01.102.

Khan MN, Ahmed A, Zafar I, Akhtar S, Aurangzeb MH, Khan A. The Diagnostic Accuracy of Carotid Doppler in Detecting Anechoic Thrombus Against CT Angiography as the Gold Standard. Cureus. 2022 Jul; 14(7).

Bollipo JP and Rao PB. Color Doppler Assessment of Extra-Cranial Carotid Arteries in Carotid Artery Disease with Correlation of Risk Factors in Predicting Cerebrovascular Accident in Patients with Carotid Atheromatous Disease. International Journal of Advances in Medicine. 2018 Dec; 5(6): 1402-1406. doi: 10.18203/2349-3933.ijam20184718.

Ou Q, Zhang J, Wen X, Yang L, Tao L. Clinical Significance of Carotid Intima-Media Thickness and Plasma Homocysteine in Acute ST-Segment Elevation Myocardial Infarction. Cardiovascular Diagnosis and Therapy. 2023 Dec; 13(6): 917. doi: 10.21037/cdt-23-312.

Katsiki N and Mikhailidis DP. Diabetes and Carotid Artery Disease: A Narrative Review. Annals of Translational Medicine. 2020 Oct; 8(19): 1280. doi: 10.21037/atm.2019.12.153.

Pratama D, Rahmaditya FS, Utama AJ, Suhartono R, Muradi A. Risk Factors of Asymptomatic Carotid Artery Disease in Geriatric Evaluated Using Carotid Intima-Media Thickness (IMT) Measurement, the First Indonesian Population Study. International Journal of Angiology. 2023 Jun; 32(02): 095-9. doi: 10.1055/s-0042-1750040.

Ghafoor N, Deepa KP, Sazzad F, Siraj N, Haque MZ, Rahman MA et al. Prevalence of Carotid Artery Stenosis in Patients Undergoing Coronary Artery Bypass Grafting: A Single-Centre Study in Bangladesh. Mymensingh Medical Journal. 2023 Oct; 32(4): 1015-21.

Gargani L, Baldini M, Berchiolli R, Bort IR, Casolo G, Chiappino D et al. Detecting the Vulnerable Carotid Plaque: The Carotid Artery Multimodality Imaging Prognostic Study Design. Journal of Cardiovascular Medicine. 2022 Jul; 23(7): 466-73. doi: 10.2459/JCM.0000000000001314.

Dossabhoy S and Arya S. Epidemiology of Atherosclerotic Carotid Artery Disease. In Seminars in Vascular Surgery. 2021 Mar; 34(1): 3-9. doi: 10.1053/j.semvascsurg.2021.02.013.

Yaqoob A, William S, Yasir M. Frequency of Significant Carotid Artery Disease on Carotid Angiography in Patients with Left Main Stem Coronary Artery Disease. The Professional Medical Journal. 2021 Aug; 28(09): 1252-6. doi: 10.29309/TPMJ/2021.28.09.6666.

Horikoshi T, Nakamura T, Yamada R, Yoshizaki T, Watanabe Y, Uematsu M et al. Association Between Carotid Plaque Progression and Persistent Endothelial Dysfunction in An Infarct-Related Coronary Artery in STEMI Survivors. Heart and Vessels. 2025 Jan; 40(1): 36-46. doi: 10.1007/s00380-024-02444-z.

Gue YX, Kanji R, Gati S, Gorog DA. MI with Non-Obstructive Coronary Artery Presenting with STEMI: A Review of Incidence, Aetiology, Assessment and Treatment. European Cardiology Review. 2020 Apr; 15: e20. doi: 10.15420/ecr.2019.13.

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Published

2025-12-31
CITATION
DOI: 10.54393/pjhs.v6i12.3534
Published: 2025-12-31

How to Cite

Khan, O., Khan, T. I., Hussain, C., & Ali, Y. (2025). Carotid Artery Doppler Study in Patients Presenting with STEMI: Carotid Artery Doppler Study with STEMI. Pakistan Journal of Health Sciences, 6(12), 08–12. https://doi.org/10.54393/pjhs.v6i12.3534

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