Abstract 16411: Can the Types of Coronary Artery Disease Severity be Predicted Using Any Parameters of Brachial Ultrasonography and/or Carotid Ultrasonography?

Abstract

Introduction: It has been reported that the flow-mediated dilatation (FMD) of the brachial artery on brachial ultrasonography and carotid intima-media thickness (IMT) on carotid ultrasonography correlate with the presence of coronary artery disease (CAD). Hypothesis: However, it is not clear whether CAD types can be detected using these techniques. We examined whether CAD types can be detected using brachial and/or carotid ultrasonography. Methods: Four hundred fifteen patients (mean age 68 years, 266 men) who underwent coronary angiography (CAG) during the evaluation of CAD were enrolled. Each patient underwent brachial and carotid ultrasonography before CAG. On brachial ultrasonography, FMD) and nitroglycerine-induce dilation (NID) were measured. On carotid ultrasonography, maximum IMT, the presences of carotid plaque (>1.1 mm) and calcification were measured. On coronary angiography, if organic coronary stenosis was absent, a spasm provocation test was performed to confirm the presence of vasospastic angina (VSA). According to the CAG results, patients were divided into three subgroups: Group I, patients with organic coronary stenosis (n = 244); Group II, patients with VSA without organic coronary stenosis (n = 98); and Group III, patients without organic coronary stenosis or VSA (n = 73). Results: FMD was lower in Groups I (3.2% ± 0.3%) and II (3.2% ± 0.4%) than in Group III (4.5% ± 0.4%, p < 0.05), and NID were lower in Group I (12.1% ± 0.4%) than in Groups II (14.6% ± 0.6%) and III (15.6% ± 0.7%, p < 0.0001). Max IMT was higher in Group I (2.38 ± 0.06 mm) than in Groups II (1.61 ± 0.09 mm) and III (1.56 ± 0.10 mm, p < 0.0001). The presence of both carotid plaque and calcification was higher in Group I (93% and 43%, respectively) than in Group II (74% and 19%, respectively) and III (60% and 19%, respectively, both p < 0.0001). Logistic regression analysis demonstrated that carotid plaque (p = 0.0162), carotid calcification (p = 0.0011) and lower NID (p = 0.0011) were predictors of the presence of Group I, whereas lower max IMT (p = 0.0002) was one of predictors for the presence of Group II. Conclusions: These findings suggest that brachial and/or carotid ultrasonography before CAG may provide important diagnostic information regarding CAD types.