Ankle–Brachial Index and Its Link to Automated Carotid Ultrasound Measurement of Intima–Media Thickness Variability in 500 Japanese Coronary Artery Disease Patients

Abstract

The purpose of this study was to evaluate whether the carotid intima-media thickness (cIMT) and intima-media thickness variability (IMTV) along the artery are correlated to the ankle-brachial index (ABI) in Japanese coronary artery disease patients. Five hundred consecutive patients (312 males; median age 69 ± 11 years) who underwent carotid ultrasonography and first coronary angiography were prospectively analyzed. By using automated software (AtheroEdge™, AtheroPoint, Roseville, CA, USA), we obtained the cIMT and IMTV. Pearson correlation analysis was performed to calculate the association between ABI, automatically measured cIMT, automatically measured IMTV, and the SYNTAX score. The mean cIMT was 0.881 ± 0.334 mm and the mean IMTV was 0.141 ± 0.112. IMTV was negatively and significantly correlated to ABI (ρ = -0.147; p = 0.001), whereas cIMT was not (ρ = -0.075; p = 0.097). IMTV and cIMT had the same significant correlation with the SYNTAX score. When we considered patients with a higher risk factor (ABI ≤ 0.9), we found higher values of IMTV and the SYNTAX score, but not higher values of cIMT. Logistic regression analysis showed that IMTV was independently associated with the complexity of the coronary artery disease (as assessed by the SYNTAX score). In conclusion, we show that IMTV automatically measured using AtheroEdge™ was correlated with ABI, whereas cIMT was not. IMTV could be integrated with cIMT measurement to improve the assessment of cardiovascular disease.

Accurate cloud-based smart IMT measurement, its validation and stroke risk stratification in carotid ultrasound: A web-based point-of-care tool for multicenter clinical trial

“…Carotid intima-media thickness (cIMT) is one of the most popular methods for monitoring CVD and predicting the occurrence of major adverse cardiovascular events. [10][11][12][13][14][15][16][17][18][19][20][21][22] Prediction of CVD has been tied to cIMT in the early studies in order to foresee cardiovascular events (CVE). Several studies have shown a relationship between threshold value of cIMT leading to CVD: (cIMT > 0.7 mm) 23 , (cIMT > 0.85 mm) 24 , (cIMT > 0.9 mm), 25,26 (cIMT > 1.0 mm) 27 , and (cIMT > 1.26 mm).…”

“…Several studies [17][18][19][20] emphasized the need for an automated system for cIMT computation. This is mainly because current manual 19 or semi-automated systems 30 used by sonographers are subjective and associated with operator or observer bias.…”

Shape‐Based Approach for Coronary Calcium Lesion Volume Measurement on Intravascular Ultrasound Imaging and Its Association With Carotid Intima‐Media Thickness

“…(3) The main objective of the proposed system is to extract calcium shapes and study the nature of the shapes of the calcium regions and their branches (Huang et al 27 implemented a similar approach for breast vascular US). Thus, the calcium region features, such as the centerline, lesion thickness, and lesion arc span, are extracted, which was not the focus of the work of Filho et al 26 (4) Unlike the work of Filho et al, 26 the most important clinical contribution of this proposed work is understanding the genetic relationship between calcium deposits in the coronary arteries and plaque in the carotid arteries and understanding the link, which is something along the lines of AtheroEdgeLink 28 , 29 . (5) Last, this work engaged a huge cohort of more than 100 volumes (≈260,000 IVUS frames), representing a larger population that is diabetic in nature and representing a particular ethnicity.…”

The Combination of the Ankle Brachial Index and Brachial Ankle Pulse Wave Velocity Exhibits a Superior Association with Outcomes in Diabetic Patients

“…However, Kawai et al validated that the efficacy of predicting cardiovascular events based on the cIMT is inferior that of the plaque score, which exhibits greater accuracy in prediction and is equivalent to the pulse wave velocity (30). In addition, Ikeda et al demonstrated the results of a cohort study of 500 Japanese patients in which the IMTV was found to be better associated with the existence of coronary artery disease than the cIMT, and the IMTV, not cIMT, was shown to correlate with the ABI (31). Consequently, the ABI and/or pulse wave velocity may be superior parameters in terms of their association with the outcomes of cardiovascular disease than the cIMT.…”