Carotid intima media thickness and subclinical early atherosclerosis

Abstract

We readwith interest the letter by Han et al. [1] regarding our paper entitled ‘Carotid intima media thickness can predict coronary artery disease’ [2]. Coronary artery disease (CAD) has led to higher mortality rate worldwide. Thus, early diagnosis of CAD is important issue indaily routine practice. Some inflammatory indicators may be observed subclinic atherosclerosis. In clinical practice, one of these indicators, carotid intima media thickness(CIMT) is widely used as an inflammatory marker [3]. CIMT measurement is easy, accessible, routine, and cheap method for evaluating the inflammatory condition or endothelial dysfunction [4]. In recent letter, Han et al. [1] have mentioned the relation between CIMT and the risk of CAD. We agree with these comments. Indeed, in many studies, the authors investigated the relation between CIMT and various conditions including CAD risk factors, inflammatory diseases, any of vascular atherosclerotic diseases [4–8]. These studies reported that CIMT would be used as inflammatory markers in routine examination in many disorders [4–8]. Moreover, CIMT values are positively correlated inflammatory disease activity levels or inflammatory status [9]. However, some confounding factors should be mentioned. One of these factors, CIMT ismeasured by using ultrasoundwith linear probe. Clinicians' experiences are important to give interobserver and intraobserver variabilities in accepted limits, when CIMT is measured. Secondly, when CIMT is used as an inflammatory marker, the authors should measure some accepted inflammatory markers like C-reactive protein and examine the relationship between them [10]. As a conclusion, although CIMT may give useful information to clinicians about the systemic inflammation [11], one should be kept in mind that these above conditions are considered, when CIMT is assessed.