Abstract
BackgroundSince cardiovascular diseases are associated with high mortality and generally undiagnosed before the onset of clinical findings, there is a need for a reliable tool for early diagnosis. Carotid intima-media thickness (CIMT) is a non-invasive marker of coronary artery disease (CAD) and is widely used in practice as an inexpensive, reliable, and reproducible method. In the current study, we aimed to investigate prospectively the relationship of CIMT with the presence and extent of significant coronary artery narrowing in patients evaluated by coronary angiography for stable angina pectoris.MethodsOne hundred consecutive patients with stable angina pectoris and documented ischemia on a stress test were included in the study. The patients were divided into two groups according to the result of the coronary angiography: group 1 (39 patients) without a noncritical coronary lesion, and group 2 (61 patients) having at least one lesion more than 50% within the main branches of the coronary arteries. All of the patients underwent carotid Doppler ultrasound examination for measurement of the CIMT by a radiologist blinded to the angiographic data.ResultsThe mean CIMT was 0.78 ± 0.21 mm in Group 1, while it was 1.48 ± 0.28 mm in Group 2 (p = 0.001). The mean CIMT in patients with single vessel disease, multi-vessel disease, and left main coronary artery disease were significantly higher compared to Group 1 (1.2 ± 0.34 mm, p = 0.02; 1.6 ± 0.32 mm, p = 0.001; and 1.8 ± 0.31 mm, p = 0.0001, respectively). Logistic regression analysis identified CIMT (OR 4.3, p < 0.001) and hypertension (OR 2.4, p = 0.04) as the most important factors for predicting CAD.ConclusionsThe findings of this study show that increase in CIMT is associated with the presence and extent of CAD. In conclusion, we demonstrated the usefulness of carotid intima-media thickness in predicting coronary artery disease but large-scale studies are required to define its role in clinical practice.
Highlights
Since cardiovascular diseases are associated with high mortality and generally undiagnosed before the onset of clinical findings, there is a need for a reliable tool for early diagnosis
We aimed to investigate the relationship between Carotid intima-media thickness (CIMT) and coronary artery disease (CAD) in patients evaluated by coronary angiography for suspected CAD
While no significant narrowing was noted in coronary arteries in 39 of 100 (39%) patients evaluated by coronary angiography, significant narrowing was noted in 61 patients (61%)
Summary
Since cardiovascular diseases are associated with high mortality and generally undiagnosed before the onset of clinical findings, there is a need for a reliable tool for early diagnosis. We aimed to investigate prospectively the relationship of CIMT with the presence and extent of significant coronary artery narrowing in patients evaluated by coronary angiography for stable angina pectoris. Many significant changes occur in the arterial wall, including endothelial dysfunction and an increase in intima-media thickness, before the onset of clinical findings, and these changes can be useful in the early diagnosis of atherosclerosis [4,5]. We aimed to investigate the relationship between CIMT and coronary artery disease (CAD) in patients evaluated by coronary angiography for suspected CAD After the first report of intima-media thickness measurement by Pignoli et al [6], rapid progress has been noted in ultrasonographic imaging methods and carotid intimamedia thickness (CIMT) has begun to be used as an inexpensive, reliable, and reproducible method in the diagnosis of atherosclerosis [7,8].
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