The relationship between carotid intima-media thickness and the presence and extent of angiographic coronary artery disease

OBJECTIVES
We investigated the relationship between carotid intima-media thickness (CIMT), a marker of early atherosclerotic changes in the arterial bed, and the presence and extent of coronary artery disease (CAD).

STUDY DESIGN
B-mode ultrasound examination of bilateral common carotid arteries and computer assisted CIMT measurements were performed following angiographic assessment of 47 patients without CAD (group 1) and 63 patients with CAD (group 2). The mean and maximum CIMT values were compared between the groups with regard to the presence and extent of CAD and the predictive value of CIMT for angiographic CAD was determined.

RESULTS
The mean and maximum CIMT values for both the right and left carotid arteries and the overall maximum and mean values were significantly higher in group 2 (p<0.001). The patients with CAD were analyzed in two subgroups depending on the extent of CAD: the mean and maximum CIMT values were 0.931 mm and 0.767 mm in those with single vessel disease, and 1.065 mm and 0.860 mm in those with multivessel disease, respectively (p<0.001). The sensitivity, specificity, positive and negative predictive values of a cutoff value of 0.956 mm for determining angiographic CAD were 85.7%, 85.1%, 88.5%, and 81.6%, respectively (area under the curve, 0.871; 95 percent confidence interval, 0.794-0.928). Regression analysis showed that maximum CIMT and diabetes were independent predictors of CAD.

CONCLUSION
Measurement of CIMT by B-mode ultrasound is a simple, noninvasive, and useful tool for early diagnosis of cardiovascular diseases and risk classification for atherosclerosis.