Predicting Coronary Artery Disease with Carotid Intima-media Thickness: Does Gender Matter

Abstract

Objectives: Atherosclerosis is the leading cause of coronary artery disease (CAD) worldwide. The gold standard for diagnosing CAD is by doing coronary angiography but this is an invasive procedure. Carotid intima-media thickness (CIMT) is a non-invasive procedure which is suggested to correlate with CAD. Materials and Methods: It was a cross-sectional study of 87 subjects who underwent angiography and carotid ultrasound for CIMT. They were divided into male and female groups with or without angiographically proven CAD. Correlations were made between the CIMT and presence of CAD and between CIMT and severity of CAD. The presence of plaque and its association with CAD was also studied. Results: Mean value of CIMT was 0.865 mm and plaque was present in 30% of the cases. In males, the severity of CAD has association with CIMT but this was not found in female gender. CIMT does not correlate with the presence or absence of CAD in either gender but the values of CIMT correlate well with the severity of CAD. This means that, higher the CIMT value more the number of vessels affected on angiography and the value with best sensitivity and specificity (from this study) was 0.88 mm. However, this correlation of CIMT with severity of CAD was restricted to male gender as findings were insignificant for females. Furthermore, the presence, morphology, or echogenicity of plaque does not correlate with severity of CAD in either gender. Conclusion: Predicting CAD from CIMT value is still inconclusive and requires further studies to look for correlations.