Clinical Value of Serological Markers and Cervical Vascular Ultrasound in the Diagnosis of Carotid Stenosis in Elderly Patients with Coronary Heart Disease

doi:10.16458/j.cnki.1007-0893.2025.12.019

Abstract：Objective: To explore the clinical value of serological markers and cervical vascular ultrasound in the diagnosis of carotid stenosis in elderly patients with coronary atherosclerotic heart disease (coronary heart disease). Methods: A total of 116 elderly patients with coronary heart disease treated at Henan Sanmenxia Hospital of Traditional Chinese Medicine from April 2022 to April 2024 were enrolled in this study. Based on the results of digital subtraction angiography (DSA) as the gold standard, all patients were divided into two groups: the non-carotid stenosis group (40 cases) and the carotid stenosis group (76 cases). Both groups underwent imaging examinations, and their serum C-reactive protein (CRP) and homocysteine (Hcy) levels were detected and compared. The consistency between cervical vascular ultrasound and the gold standard was analyzed. The diagnostic efficiency of serum CRP, Hcy, cervical vascular ultrasound, and their combination for carotid stenosis in coronary heart disease was evaluated. Results: The peak systolic velocity (PSV) and end-diastolic velocity (EDV) of the common carotid artery in the carotid stenosis group were lower than those in the non-carotid stenosis group, while the resistance index (RI), serum CRP, and Hcy levels were higher, with statistically significant differences (P < 0.05). The sensitivity and specificity of cervical vascular ultrasound for diagnosing carotid stenosis in coronary heart disease were 78.95% and 75.00%, respectively, with a Kappa value of 0.795 (P < 0.05) compared to the gold standard. The sensitivity and specificity of combined CRP and Hcy diagnosis were 94.74% and 95.00%, respectively, which were higher than those of single-item diagnosis (P < 0.05). The area under the curve (AUC) of the combined diagnosis of cervical vascular ultrasound, CRP, and Hcy was 0.990, significantly higher than that of individual tests (P < 0.05). Conclusion: The combination of imaging examination and serological markers has high clinical value in the diagnosis of carotid stenosis in elderly patients with coronary heart disease.