The online version of this article (doi:10.1186/1476-7120-7-59) contains supplementary material, which is available to authorized users.
The authors declare that they have no competing interests.
UC: Participated in performance of coronary angiograms, data analysis and drafting of the manuscript.
AY: Participated in performance and interpretation of coronary angiograms and drafting of the manuscript.
OBE: Participated in data collection, drafting and final revision of the manuscript.
MB: Participated in data collection and coordination of the study.
MAC: Performed the statistical analysis
KOK: Participated in data collection and coordination of the study.
LAO: Participated in data collection and coordination of the study.
SY: Performed the carotid Doppler examinations
All authors read and approved the final manuscript.
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. Carotid intima-media thickness (CIMT) is a non-invasive marker of coronary artery disease (CAD) and is widely used in practice as an inexpensive, reliable, and reproducible method. In the current study, we aimed to investigate prospectively the relationship of CIMT with the presence and extent of significant coronary artery narrowing in patients evaluated by coronary angiography for stable angina pectoris.
One hundred consecutive patients with stable angina pectoris and documented ischemia on a stress test were included in the study. The patients were divided into two groups according to the result of the coronary angiography: group 1 (39 patients) without a noncritical coronary lesion, and group 2 (61 patients) having at least one lesion more than 50% within the main branches of the coronary arteries. All of the patients underwent carotid Doppler ultrasound examination for measurement of the CIMT by a radiologist blinded to the angiographic data.
The mean CIMT was 0.78 ± 0.21 mm in Group 1, while it was 1.48 ± 0.28 mm in Group 2 (p = 0.001). The mean CIMT in patients with single vessel disease, multi-vessel disease, and left main coronary artery disease were significantly higher compared to Group 1 (1.2 ± 0.34 mm, p = 0.02; 1.6 ± 0.32 mm, p = 0.001; and 1.8 ± 0.31 mm, p = 0.0001, respectively). Logistic regression analysis identified CIMT (OR 4.3, p < 0.001) and hypertension (OR 2.4, p = 0.04) as the most important factors for predicting CAD.
The findings of this study show that increase in CIMT is associated with the presence and extent of CAD. In conclusion, we demonstrated the usefulness of carotid intima-media thickness in predicting coronary artery disease but large-scale studies are required to define its role in clinical practice.
Gaziano JM: Global burden of cardiovascular disease. Heart disease: A textbook of cardiovascular medicine. Edited by: Braunwald E, Zipes DP, Libby P. Philadelphia: WB Saunders Company, 6, 2001, 1-17.
Onat A, Sansoy V, Soydan , Tokgozoglu L, Adalet K: TEKHARF; On iki yillik izleme deneyimine gore Turk eriskinlerinde kalp sagligi. Istanbul: ARGOS Iletisim, 2003.
Kuller L, Borhani N, Furberg C, Gardin J, Manolio T, O'Leary D, Psaty B, Robbins J: Prevalence of subclinical atherosclerosis and cardiovascular disease and association with risk factors in the Cardiovascular Health Study. Am J Epidemiol. 1994, 139: 1164-1179. PubMed
Greenland P, Abrams J, Aurigemma GP, Bond MG, Clark LT, Criqui MH, Crouse JR, Friedman L, Fuster V, Herrington DM, Kuller LH, Ridker PM, Roberts WC, Stanford W, Stone N, Swan HJ, Taubert KA, Wexler L: 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: E16-E22. CrossRefPubMed
Altekin ER, Demir I, Basarici I, Yilmaz H: The relationship between carotid intima-media thickness and the presence and extent of angiographic coronary artery disease. Turk Kardiyol Dern Ars. 2007, 35: 90-96.
Chambless LE, Heiss G, Folsom AR, Rosamond W, Szklo M, Sharrett AR, Clegg LX: Association of coronary heart disease incidence with carotid arterial wall thickness and major risk factors: the Atherosclerosis Risk in Communities (ARIC) Study, 1987-1993. Am J Epidemiol. 1997, 146: 483-494. CrossRefPubMed
O'Leary DH, Polak JF, Kronmal RA, Manolio TA, Burke GL, Wolfson SK: Carotid-artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults. Cardiovascular Health Study Collaborative Research Group. N Engl J Med. 1999, 340: 14-22. 10.1056/NEJM199901073400103 CrossRefPubMed
Touboul PJ, Hernandez-Hernández R, Kucukoglu S, Woo KS, Vicaut E, Labreuche J, Migom C, Silva H, Vinueza R, PARC-AALA Investigators: Carotid artery intima media thickness, plaque and Framingham cardiovascular score in Asia, Africa/Middle East and Latin America: the PARC-AALA study. Int J Cardiovasc Imaging. 2007, 23: 557-567. 10.1007/s10554-006-9197-1 CrossRefPubMed
Demircan S, Tekin A, Tekin G, Topcu S, Yigit F, Erol T, Katircibasi T, Sezgin AT, Baltali M, Ozin B, Müderrisoglu H: Comparison of carotid intima-media thickness in patients with stable angina pectoris versus patients with acute coronary syndrome. Am J Cardiol. 2005, 96: 643-644. 10.1016/j.amjcard.2005.04.035 CrossRefPubMed
- Relationship between carotid intima-media thickness and coronary angiographic findings: a prospective study
Ozlem B Esen
Mehmet A Cakar
Kadriye O Kilickesmez
Lutfu A Orhan
- BioMed Central
Neu im Fachgebiet Innere Medizin
Meistgelesene Bücher aus der Inneren Medizin
Mail Icon II