Author + information
- Seung-Hwan Lee,
- Jun-Won Lee,
- Young-Jin Youn,
- Sung Gyun Ahn,
- Min-Soo Ahn,
- Jang-Young Kim,
- Byung-Su Yoo,
- Junghan Yoon and
- Kyung-Hoon Choe
Carotid ultrasonography is a good non-invasive modality to evaluate atherosclerotic changes. Intima-media thickness (IMT) is a well-established surrogate marker of coronary atherosclerosis. But, the role of other carotid parameters for predicting coronary artery disease (CAD) is still lack of evidence. Therefore, we evaluated the correlation between carotid parameters and SYNTAX score (SS) representing the severity and extent of CAD. We also investigated whether carotid parameters predict the presence of CAD or not.
Total 663 of 1698 patients (408 men, mean age: 64.1 ± 11.9 years) who performed both carotid ultrasonography and coronary angiography during admission from Sep 2011 to Aug 2012 were studied. The patients were divided into three groups: normal or minimal CAD, 1 vessel disease (VD) and ≥2VD. Plaque score (PS) was defined as a numerical summation of the presence of plaque in 4 different locations of both carotid arteries. Maximum % diameter stenosis (DS) and area stenosis (AS) were measured at the narrowest portion in longitudinal and short axis view.
The old age, male gender, diabetes mellitus and smoking were significantly related to the extent of CAD. All carotid parameters showed significant relationship with the extent of CAD. Mean carotid IMT, maximum carotid IMT, PS, %AS and %DS were weakly but significantly correlated with SS (r=0.226, 0.162, 0.336, 0.361, 0.318, respectively, all p value < 0.001). After adjusted for classic risk factors, PS was the best predictor for CAD (Odds ratio 1.576, 95% confidence interval 1.365-1.820, p<0.001). The diagnostic accuracy of PS for the detection of CAD by the area under the receiver operating characteristics curve was 0.702 (95% confidence interval 0.661-0.743, p<0.001).
All carotid parameters were weakly but significantly correlated with SYNTAX score. PS was a good predictor for coronary artery disease. Long-term follow-up is warranted to discriminate clinical outcomes using carotid ultrasonographic parameters.
- 2013 American College of Cardiology Foundation