Role of Carotid Intima-Media Thickness and Carotid Plaque in Predicting Significant Coronary Artery Stenosis in Thai Patients with Chronic Coronary Syndrome: A Cross-Sectional Study

Abstract

Objective: To evaluate the diagnostic role of carotid artery intima-media thickness and plaque for significant coronary artery disease (CAD) in Thai patients with chronic coronary syndrome (CCS) when coronary angiography (CAG) was indicated. Material and Methods: The present study cross-sectional study included adult patients diagnosed with CCS admitted for elective CAG. One day prior or on the day of the procedure, carotid ultrasonography was performed, and diagnostic values of this test were calculated. Results: One hundred patients, including 69 males and 31 females, with a mean age ± standard deviation of 62.6±12.2 years were recruited. Sixty-three patients had significant CAD, of which carotid plaque (CP) was an independent risk factor (adjusted odds ratio 3.63, 95% confidence interval 1.17 to 11.22, p=0.025). From which, CP had a 29% prevalence, and provided a sensitivity, specificity, positive predictive value, and negative predictive value of 38%, 86%, 83%, and 45%, respectively, in predicting the disease. There was a weak correlation between carotid intima-media thickness and a significant disease (r=0.279, p=0.05), in addition to poor diagnostic accuracy of the calculated optimal cut-off value (area under the curve=0.68, p<0.05). Conclusion: CP was common, and specific for significant CAD in CCS with mild symptoms. This parameter might facilitate discriminating those having significant disease. Keywords: Carotid plaque; Coronary artery disease; Intima-media thickness; Ultrasonography