CVUS: Carotid intima-media thickness can predict presence, extent of CAD

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When examining the correlation between carotid intima-media thickness (CIMT) and coronary artery disease (CAD), researchers found that the utilization of CIMT can predict CAD, according to a study published in the Dec. 31 issue of Cardiovascular Ultrasound (CVUS).

“Since cardiovascular diseases are associated with high mortality and generally undiagnosed before the onset of clinical findings, there is a need for a reliable tool for early diagnosis,” the authors wrote. “CIMT is a non-invasive marker of CAD and is widely used in practice as an inexpensive, reliable and reproducible method.”

Ugar Coskun, MD, of the department of medical oncology at the Gazi University Medical School in Turkey, and colleagues studied 100 patients to understand the relationship between CIMT and the “presence and extent” of CAD.

Of the 100 patients, all had stable angina pectoris, had been recorded as having ischemia on their stress tests and were being evaluated via coronary angiography.

During the investigation, study participants were split into two groups dependent upon results of their coronary angiography. Group one consisted of 39 patients who showed no signs of a critical coronary lesion, while group two consisted of 61 patients who had at least one lesion placed more than 50 percent within the main branches of their coronary artery.

To examine the relationship between CIMT and CAD, patients underwent a carotid Doppler ultrasound exam in order to record measurements of the CIMT.

The carotid scans were performed using GE Healthcare’s Logiq 9 ultrasonography device, which featured a 10 MHz linear probe. Results were found after measuring the CIMT at a 1 cm distance to the bulbus over a length of 1 cm of both carotid arteries.

According to the authors, measurements were taken in five locations on the far-wall and then evaluated using the average of the right and left carotid arteries as the final CIMT.

According to the results, significant narrowing was found in the 61 patients in group two. While group two had more hypertensive, diabetic and hyperlipidemic patients than group one, the authors noted that there was no significant difference in terms of age, gender and smoking habits.

The authors reported that the mean CIMT measurement was higher in patients in group two, compared to group one,1.48 and 0.78, respectively.

The American Heart Association deems CIMT measurement as the “most useful method to identify atherosclerosis.” In previous studies where the risks of atherosclerosis and cardiovascular health were analyzed, researchers found a direct correlation between increased CIMT and an increased risk of CAD, including MI and stroke, according to the authors.

During this study, the authors found that increases in CIMT numbers occurred as the number of coronary vessels involved increased. Highest CIMT values were depicted in patients with left main coronary involvement. Also, the authors noted that thickening of the mean intima-media complex to more than one was predictive of “significant” CAD.

According to the authors, the most significant factors for predicting CAD were hypertension and CIMT.

While the authors noted that the value of using of CIMT was demonstrated, they said that large-scale studies are still needed in order to “define its role in clinical practice.”