scholarly journals Carotid intima-media thickness as a marker for assessing the severity of coronary artery disease on coronary angiography

Author(s):  
Asif S. Wani ◽  
Zafirah . ◽  
Samia Rashid ◽  
Hanief M. Tantray

Background: Coronary artery disease (CAD), the leading cause of death worldwide, has a huge area of primary prevention where patients at risk can be identified for more intensive, evidence-based medical interventions to reduce cardiovascular events. Whereas coronary angiography has stood the test of time to assess atherosclerotic burden, it is still unavailable to a huge population at risk of CAD. This study was devised in search of a cheap and simple tool to assess atherosclerotic burden. 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 and whether CIMT could predict the extension of CAD.Methods: This study was a cross-sectional study conducted from March 2013 to September 2015 in Department of Medicine, SMHS Hospital, J and K, India. A total of 100 patients admitted to for undergoing coronary angiography indicated for suspected coronary artery disease were enrolled. the risk factors evaluated in this study included age, body mass index, sex, dyslipidemia, hypertension, diabetes mellitus and smoking. CAD was assessed and classified by coronary angiography and CIMT was assessed by carotid doppler.Results: There was a positive relationship between CIMT and CAD. Risk factors like Age, smoking, BMI, cholesterol, hypertension, and diabetes had significant positive effect on CIMT; whereas gender, VLDL, triglycerides, HDL and LDL were statistically insignificant in affecting CIMT.Conclusions: CIMT is a cheap and simple tool to predict the extent of CAD.

2019 ◽  
Vol 20 (8) ◽  
pp. 889-896
Author(s):  
Mingjun Xu ◽  
Mei Zhang ◽  
Jinfeng Xu ◽  
Mei Zhu ◽  
Cheng Zhang ◽  
...  

Abstract Aims Carotid intima-media thickness (CIMT) has been widely used to risk stratify and predict coronary artery disease (CAD) despite its significant limitations. To test whether radial artery intima thickness (RIT) is closely associated with atherosclerotic risk factors, and whether RIT has an independent and additive value for diagnosis of CAD. Methods and results One hundred and sixteen consecutive CAD patients and 79 age and gender-matched healthy controls were enrolled in this study. RIT, radial media thickness, radial intima-media thickness, and CIMT were measured with a high-resolution ultrasound biomicroscopy. Binary logistic regression was used to assess association between CAD and ultrasonic parameters, biochemical biomarkers or traditional risk factors. Receiver-operating characteristic curves were plotted to compare performances of several diagnostic models. RIT was positively associated with age, systolic blood pressure, statin administration, and hypertension. The independent value of RIT for differentiating CAD was similar to that of CIMT, but the add-on value of RIT to traditional risk factors for detecting CAD was superior to that of CIMT. Moreover, addition of RIT and CIMT to traditional risk factors increased AUC for detecting CAD from 0.724 to 0.867 significantly (P = 0.003). Conclusion RIT could detect CAD independently similarly to CIMT. The add-on value of RIT to traditional risk factors for detecting CAD was superior to CIMT and addition of RIT and CIMT to traditional risk factors markedly increased the power to diagnose CAD. Thus, RIT measured by ultrasound biomicroscopy provided a novel approach to non-invasive diagnosis of CAD.


2003 ◽  
Vol 11 (3) ◽  
pp. 217-221 ◽  
Author(s):  
Gupta Hansa ◽  
Kartikeya Bhargava ◽  
Manish Bansal ◽  
Sharad Tandon ◽  
Ravi R Kasliwal

To determine whether carotid intima-media thickness is associated with coronary artery disease and cardiovascular risk factors in the Indian population, carotid intima-media thickness was measured using high-resolution B-mode ultrasonography in 101 patients with coronary artery disease and 140 control subjects. Carotid intima-media thickness was measured at 3 predefined sites on each side. The maximum carotid intima-media thickness was significantly higher in the coronary disease group compared to the controls (1.02 vs. 0.80 mm). The average intima-media thickness was also significantly higher in the coronary disease group (0.82 vs. 0.67 mm). On multivariate logistic regression analysis, carotid intima-media thickness was the only factor found to be an independent predictor of coronary artery disease. There was a significant association between risk factor count and the average and maximum intima-media thickness values in the combined study population. These results indicate that raised values of average and maximum carotid intima-media thickness are significantly associated with the presence of coronary artery disease and this association is independent of the presence of other conventional cardiovascular risk factors.


1977 ◽  
Author(s):  
S. K. Durairaj ◽  
A. H. Khan ◽  
L. J. Haywood

Risk factors were compared in 42 patients (pts) with coronary artery disease (CAD) and 18 with radiographically patent arteries (RPA) on angiography performed three weeks to six months after documented myocardial infarction (Ml). All pts had typical clinical and laboratory findings during the acute attack. All pts were below age 50 and both groups had a similar distribution of racial background (Caucasian, black and Mexican-American). Psychiatric problems were not more frequent in either group. The data demonstrated a high prevalence of standard risk factors in the CAD group for hypertension (28 of 42 = 67%), hypercholesterolemia (25 of 42 = 60%) and smoking (17 of 42 = 64%), and similarly high prevalence of smoking (16 of 18 = 89%), heavy labor (12 of 18 = 61%) and obesity (9 of 18 = 50%) in the RPA group. Factors significantly more common in the CAD group as compared to the RPA group by the Chi Square test were:Hypertension (P < 0.001), hypercholesterolemia (P < 0.001), diabetes (P < 0.001), and family history (P < 0.05). Factors more common in the RPA group were heavy alcohol consumption (P < 0.001), smoking (P < 0.05), heavy laborer occupation (P < 0.001) and obesity (P < 0.001). The data suggest that risk factor screening would identify individuals at risk from coronary artery disease but would be unreliable in identifying individuals at risk for MI with RPA. Further study is indicated to determine what factors operate to produce ischemia and infarction in the RPA group of pts.


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