Association of increased carotid intima-media thickness with the extent of coronary artery disease

Abstract

Objective: To investigate (a) the relation between intima-media thickness (IMT) in carotid arteries and the extent of coronary artery disease (CAD); and (b) whether IMT is predictive of coronary atherosclerosis. The coexistence of severe extracranial atherosclerosis in patients with CAD was also analysed. Methods: Coronary angiography and carotid ultrasound evaluation were performed in 558 consecutive patients (438 men), with a mean (SD) age of 58.8 (9.2) years and suspected CAD. Mean IMT was measured at both carotid arteries and expressed as the mean aggregate value. The relation between IMT and severity of CAD was determined. Results: A significant correlation between mean IMT and advancing CAD (p , 0.0001) was found. Four independent predictors of CAD were found in the discriminant analysis: age (p = 0.0193), hyperlipidaemia (p , 0.0001), smoking (p = 0.0032), and IMT (p , 0.0001). A significant increase in IMT was observed among patients with one, two, and three vessel CAD. A log normal distribution of IMT values showed that if mean IMT was over 1.15 mm, patients had a 94% probability of having CAD, with sensitivity of 65% and specificity of 80% in the patients with a high risk of CAD. The number of critically stenosed extracranial arteries increased with advancing CAD. None of the patients with normal coronary arteries had severe stenosis of the extracranial arteries. Severe carotid, vertebral, or subclavian stenosis was found in 16.6% of patients with three vessel CAD. Conclusions: IMT increases with advancing CAD, patients with mean IMT over 1.15 mm have a 94% likelihood of having CAD, and the coexistence of CAD with severe stenosis of aortic arch arteries is relatively high and was found in 16.6% of patients with three vessel CAD.

Association of Coronary Artery Stenosis with Carotid Atherosclerosis in Asymptomatic Type 2 Diabetic Patients

“…Many prospective studies have shown that the development of carotid IMT progressed to cardiovascular events [15][16][17] . Cross-sectional studies showed that carotid IMT was associated with coronary artery stenosis assessed by coronary angiography [18][19][20][21][22] , and this conclusion is consistent with the findings of our study.…”

“…Previous studies have established carotid arterial wall thickness as one of the most reliable markers for systemic atherosclerosis, and many studies have shown that carotid intima-media thickness (IMT) is associated with cardiovascular events and coronary artery stenosis [15][16][17][18][19][20][21][22][23] ; however, the usefulness of the evaluation of carotid IMT for CAD screening by CCTA is not clear. In addition, mean-IMT of CCA has been the focus of most previous studies, and there is no evidence of a connection between max-IMT and coronary artery stenosis [15][16][17][18][19][20][21][22][23] .…”

“…In addition, mean-IMT of CCA has been the focus of most previous studies, and there is no evidence of a connection between max-IMT and coronary artery stenosis [15][16][17][18][19][20][21][22][23] . To evaluate the utility of carotid IMT (mean-IMT and max-IMT) for CAD screening, we investigated the association of coronary artery stenosis assessed by CCTA with carotid IMT in asymptomatic type 2 diabetic patients.…”

Assessment of Oxidative Stress Markers and Carotid Artery Intima-Media Thickness in Elderly Patients Without and with Coronary Artery Disease

“…Cardiovascular study in young Finns study done by Raitakeri et al [37] and study by Kablak et al [38] showed similar relation of smoking with CIMT as observed in the current study. Yamasaki et al [39], Anath Oren et al [27] in the ARYA study, Cardiovascular Risk in Young Finns study done by Raitakari et al [37] and the ARIC study done by Howard et al [29] demonstrated that LDL-C, total cholesterol was positively associated with significant increase in CIMT.…”

Polymorphisms of the methylenetetrahydrofolate reductase, vascular endothelial growth factor, endothelial nitric oxide synthase, monocyte chemoattractant protein-1 and apolipoprotein E genes are not associated with carotid intima-media thickness

“…Our observations are consistent with those of several previous studies (20,21). Crouse et al (22) found a strong association between coronary artery status, verified by coronary angiography, and mean aggregate cIMT.…”