Vnitr Lek 2026, 72(6):E6-E10 | DOI: 10.36290/vnl.2026.076

Carotid Plaque Score and the Risk of Coronary Artery Disease in Patients with Arterial Hypertension

Danka Škultétyová, Slavomíra Filipová, Ján Postulka

Oddelenie neinvazívnej kardiológie, Národný ústav srdcových a cievnych chorôb, Bratislava

Introduction: Cardiovascular diseases (CVD) are the most common cause of death in Europe. 2023 European Society of Hypertension Guidelines for the management of arterial hypertension (AH) recommend looking for hypertension-mediated organ damage.

Aim: We investigated whether carotid plaque score (CPS) may be useful in diagnostics of coronary artery disease. We analyzed relationships between CPS and the coronary artery calcium score (CACS), as well as with coronary computed tomography angiography (CCTA).

Patients and methods: We examined 50 high risk hypertensive patients with an average age of 67±8 years with suspected or confirmed coronary artery disease. All patients were examined using computed tomography (CT). CPS was measured according to the recommendations for the assessment of carotid arterial plaque by ultrasound from the American Society of Echocardiography (3). CACS was calculated according to the Agatston score. The coronary artery stenosis was determined using the CAD-RADS (Coronary Artery Disease-Reporting and Data System) classification.

Results: Hemodynamic non significant carotid plaques were found in 41 patients (82%). The average CPS values were 3±3. Increased CACS was present in 36 patients (72%), an average of CACS = 345±463 indicating a moderate to severe risk for a major adverse cardiac events. According to CCTA the coronary artery stenoses were mild non obstructive (CADS-RADS = 2 ± 1) in the range of 25 - 49%. We analyzed the univariant relationships between CPS, PP, age and CACS, as well as with CADS-RADS classification. CACS was positively correlated with CPS (rs = 0,63, p < 0,001) and with the age (rs = 0,287, p = 0,046). Coronary artery stenoses were correlated with CPS (rs = 0,3872, p = 0,008). Multivariate regression analysis confirmed significant correlations between CPS and CACS (β = 0,400, p = 0,006), as well as between CPS and CAD-RADS classification (β = 0,368, p = 0,017).

Conclusions: We assume that based on the results of the multivariate regression analysis CPS may be useful in diagnostics of coronary artery disease. Increased values CPS may reflect risk of coronary artery calcification as well as coronary artery stenosis.

Keywords: carotid plaque score, coronary artery calcium score, CT coronary angiography.

Accepted: September 16, 2026; Published: October 2, 2026  Show citation