Carotid Intima-media Thickness as a Non-invasive Predictive Imaging Tool for Occurrence and Severity of Coronary Artery Disease: Correlations with Lipid Profile
Hossam-Eldin M. Mahmoud
Department of Internal Medicine, Faculty of Medicine, South Valley University, Qena, Egypt.
Ghada Abdelrazek
Department of Radiology, Faculty of Medicine, South Valley University, Qena, Egypt.
Mohammed H. Hassan *
Department of Medical Biochemistry, Faculty of Medicine, South Valley University, Qena, Egypt.
*Author to whom correspondence should be addressed.
Abstract
Background: It is important to identify patients at risk of developing cardiovascular events to enable preventive interventions and promote lifestyle modifications. Carotid intima–media thickness (CIMT) is an important marker for cardiovascular disease and can be easily measured by a noninvasive test. Increased CIMT has been highly suggested to be associated with coronary artery disease (CAD).
Aim: We aimed to investigate the relationship of CIMT with the presence and extent of significant coronary artery narrowing in patients evaluated by coronary angiography.
Methods: The study was conducted on 100 patients. All of them were subjected to full history taking and clinical examination. Laboratory investigations including: lipid profile [cholesterol, triglycerides, LDL-C (low density lipoprotein), HDL-C (high density lipoprotein)], HbA1c (glycated hemoglobin) in diabetics, CRP (C-reactive protein), ECG (electrocardiogram), Echocardiography, carotid Doppler and coronary angiography.
Results: There was a strong positive significant association between abnormal mean IMT and presence of CAD with p value <0.001. We found no significant association between abnormal mean IMT and extent of CAD (number of diseased coronary arteries). Increased CIMT appears to be the most independent factor affect occurrence of coronary artery disease with odds ratio (OR) 5.97 (p value 0.01) followed by CRP level OR 1.50 (p value 0.007), followed by abnormal HDL level OR 1.32 (p value 0.001) and cholesterol level OR 1.02 (p value 0.02).
Conclusions: Thus, the increased CIMT can be used as a predictor of presence of CAD but not of its extent.
Keywords: Atherosclerosis, Carotid Intima Media Thickness (CIMT), Coronary Artery Disease (CAD), coronary angiography, carotid duplex.