Abstract 16399: Carotid Intima-Media Thickness is Not Related to Angiographic Coronary Artery Disease - Importance of Carotid Plaque Scores
Introduction: Carotid intima-media thickness (CIMT) is considered to be a surrogate marker of atherosclerotic disease. Moreover, population studies have shown CIMT to be predictive of cardiovascular events. However, ultrasound methodologies for measuring CIMT have varied and in some instances have incorporated measurement of manifest atherosclerotic plaque. As separate entities, the relationship of CIMT and carotid plaque with angiographic CAD and cardiovascular outcome is unclear.
Methods: Carotid ultrasound examination was performed in consecutive patients who underwent coronary angiography for evaluation of stable or acute chest pain. Mean, maximal CIMT and plaque measurements were made in accordance with the Mannheim consensus statement. IMTmax represented the maximal plaque thickness or in the absence of plaque was the maximal CIMT measurement.
Results: A total of 146 subjects were recruited into the study with a mean age of 56.9 ± 10.6 (range 29 to 85) years; 120 were men (82%) and 26 (18%) women. Twenty-one percent of the study population had normal coronary angiography, 42% had stable CAD and 37% had presented with ACS. The table below shows a comparison of carotid parameters with extent of CAD.
Whereas CIMT measurements were similar in those with and without CAD, measurements incorporating carotid plaque (IMTmax and plaque score) were significantly higher in the CAD groups. Spearman’s rank correlation analysis showed significant positive relationships of IMTmax (r=0.32, p<0.001) and plaque score (r=0.42, p<0.001) with presence of CAD. Finally, correlation of carotid parameters with CAD syntax score showed a significant positive relationship with IMTmax (r=0.22, p=0.008) only.
Conclusions: CIMT measurement is not associated with angiographic CAD. Identifying carotid plaque and a composite score of CIMT with plaque (IMTmax) may be more useful in risk stratification and prediction of coronary artery disease and cardiovascular events.
- © 2013 by American Heart Association, Inc.