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

Asif S. Wani; Zafirah .; Samia Rashid; Hanief M. Tantray

doi:10.18203/2320-6012.ijrms20181283

Authors

Asif S. Wani Department of Medicine, SMHS Hospital, Srinagar, Jammu and Kahmir, India
Zafirah . Department of Medicine, SMHS Hospital, Srinagar, Jammu and Kahmir, India
Samia Rashid Department of Medicine, SMHS Hospital, Srinagar, Jammu and Kahmir, India
Hanief M. Tantray Department of Radiology, SMHS Hospital, Srinagar, Jammu and Kahmir, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20181283

Keywords:

Atherosclerosis, Carotid intima media thickness, Coronary artey disease

Abstract

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.

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References

Murray CJ, Ezzati M, Flaxman AD, Lim S, Lozano R, Michaud C, et al. GBD 2010: design, definitions, and metrics. Lancet. 2012;380(9859):2063-6.

Robinson J, Gidding S. Curing Atherosclerosis Should Be the Next Major Cardiovascular Prevention Goal. J Ame Coll Cardiol. 2014;63(25):2779-85.

Gallino A, Aboyans V, Diehm C, Cosentino F, Stricker H, Falk E. Non-coronary atherosclerosis. European Heart J. 2014;35(17):1112-9.

Greenland P, Abrams J, Aurigemma GP, Bond MG, Clark LT, Criqui MH, et al. Prevention Conference V: Beyond secondary prevention: identifying the high-risk patient for primary prevention: noninvasive tests of atherosclerotic burden: Writing Group III. Circulation. 2000;101(1):e16-22.

Taylor A, Merz C, Udelson J. Executive summary-can atherosclerosis imaging techniques improve the detection of patients at risk for ischemic heart disease?. J Ame Coll Cardiol. 2003;41(11):1860-2.

Michos ED, Vasamreddy CR, Becker DM, Yanek LR, Moy TF, Fishman EK, Becker LC, Blumenthal RS. Women with a low Framingham risk score and a family history of premature coronary heart disease have a high prevalence of subclinical coronary atherosclerosis. Ame Heart J. 2005;150(6):1276-81.

Michos ED, Nasir K, Braunstein JB, Rumberger JA, Budoff MJ, Post WS, et al. Framingham risk equation underestimates subclinical atherosclerosis risk in asymptomatic women. Atherosclerosis. 2006;184(1):201-6.

Nasir K, Michos ED, Blumenthal RS, Raggi P. Detection of high-risk young adults and women by coronary calcium and National Cholesterol Education Program Panel III guidelines. J Ame Coll Cardioy. 2005;46(10):1931-6.

Tierney ES, Gauvreau K, Jaff MR, Gal D, Nourse SE, Trevey S, O’Neill S, Baker A, Newburger JW, Colan SD. Carotid artery intima-media thickness measurements in the youth: reproducibility and technical considerations. J Ame Soci Echocardio. 2015;28(3):309-16.

O'leary DH, Bots ML. Imaging of atherosclerosis: carotid intima–media thickness. Euro heart J. 2010;31(14):1682-9.

Greenland P, Abrams J, Aurigemma GP, Bond MG, Clark LT, Criqui MH, et al. Prevention Conference V: Beyond secondary prevention: identifying the high-risk patient for primary prevention: noninvasive tests of atherosclerotic burden: Writing Group III. Circulation. 2000;101(1):e16-22.

Nambi V, Chambless L, Folsom AR, He M, Hu Y, Mosley T, Volcik K, Boerwinkle E, Ballantyne CM. Carotid intima-media thickness and presence or absence of plaque improves prediction of coronary heart disease risk: the ARIC (Atherosclerosis Risk In Communities) study. J Ame Coll Cardiol. 2010;55(15):1600-7.

Finn AV, Kolodgie FD, Virmani R. Correlation between carotid intimal/medial thickness and atherosclerosis: a point of view from pathology. Arteriosclerosis, thrombosis, and vascular biology. 2010;30(2):177-81.

Chen PC, Chien KL, Su TC, Jeng JS, Hsu HC, Lee YT. Carotid Atherosclerosis Progression and Risk of Cardiovascular Events in a Community in TaiwanPei-Chun Chen. Euro J Pub Heal. 2015;25(3).

Touboul P. Intima-Media Thickness and Plaque Evaluation: Predictive Value of Cardiovascular Events and Contribution to Cardiovascular Risk Evaluation. Noninvasive Vascular Diagnosis. 2017;171-5.

Tarkin JM, Dweck MR, Evans NR, Takx RA, Brown AJ, Tawakol A, et al. Imaging atherosclerosis. Circulation Res. 2016;118(4):750-69.

Zacharatosa H, Hassana AE, Quereshia AI. Intravascular ultrasonography available tool for assessment of coronary atherosclerosis. Am J Neuro Radiol. 2010;31:586-97.

Cheng H, Patel B, Martin S, Blaha M, Doneen A, Bale B, et al. Effect of comprehensive cardiovascular disease risk management on longitudinal changes in carotid artery intima-media thickness in a community-based prevention clinic. Arch Med Sci. 2016;4:728-35.

Ren L, Cai J, Liang J, Li W, Sun Z. Impact of cardiovascular risk factors on carotid intima-media thickness and degree of severity: a cross-sectional study. PLOS ONE. 2015;10(12):e0144182.

Kablak-Ziembicka A, Tracz W, Przewlocki T, Pieniazek P, Sokolowski A, Konieczynska M. Association of increased carotid intima-media thickness with the extent of coronary artery disease. Heart. 2004;90:1286-90.

Hansa G, Bhargava K, Bansal M, Tandon S, Kasliwal RR. Carotid Intima-Media Thickness and Coronary Artery Disease: an Indian Perspective. Asian Cardiovasc Thorac Ann. 2003;11:217-2.

Holaj R, Spacil J, Petrasek J, Malik J, Haas T, Aschermann M. Intima-media thickness of the common carotid artery is the significant predictor of angiographically proven coronary artery disease. Canadian J Cardiol. 2003;19(6):670-6.

Meenakshisundaram R, Devidutta S, Michaels AD, Senthilkumaran S, Rajendiran C, Thirumalaikolundusubramanian P. Significance of the Intima-Media thickness of carotid and thoracic aorta in coronary artery disease in the South Indian population. 2011;12(4):150-6.

Rosvall M, Persson M, Östling G, Nilsson P, Melander O, Hedblad B. Risk factors for the progression of carotid intima-media thickness over a 16-year follow-up period: The Malmö Diet and Cancer Study. Atherosclerosis. 2015;239(2):615-21.

Freedman DS, Dietz WH, Tang R, Mensah GA, Bond MG, Urbina EM, et al. The relation of obesity throughout life to carotid intima-media thickness in adulthood: the Bogalusa Heart Study. Inter J Obesity. 2004;28:159-66.

Ugur Coskun U, Yildiz A, Esen OB, Baskurt M, Cakar MA, Kilickesmez KO, et al. Relationship between carotid intima-media thickness and coronary angiographic findings: a prospective study. Cardiovascular Ultrasound. 2009;7:59.

Haffner SM, Agostino RD, Saad MF, O’Leary DH, Savage PJ, Rewers M, et al. Carotid artery atherosclerosis in type-2 diabetic and non-diabetic subjects with and without symptomatic coronary artery disease (The Insulin Resistance Atherosclerosis Study). Am J Cardiol. 2000;85(12):1395-400.