[Relationship between carotid intima-media thickness, atherosclerosis risk factors and angiography findings in patients with coronary artery disease]

Abstract

The aim was to determine relationship between carotid intima-media thickness and atherosclerosis risk factors and angiographic findings in patients with coronary artery disease.

Methods: We examined 172 consecutive patients, men and women, aged 58.5 +/- 9.35 years. Eligibility criteria included presence of coronary artery disease that was defined as a history of a heart attack or cardiac catheterization demonstrating > 50% stenosis of at least 1 coronary artery. B-mode ultrasound quantification of carotid artery intima-media thickness was obtained in all patients. Intima-media thickness was measured at left and right carotid arteries and expressed as the mean of the maxima in the common carotid artery, bifurcation and the internal carotid artery. Moreover, the mean of the maxima (IMT) was calculated at all sites. A grade of stenosis was identified and quantified by analyzing Doppler velocity spectrum in combination with measurement of stenosis area in all patients with severe lesions. Obtained results were compared with risk factors of atherosclerosis and angiographic findings on coronary artery angiograms.

Results: There was a statistically significant positive correlation between age (p = 0.0001), hypertension (p = 0.0001), hyperlipidaemia (p = 0.008), non-insulin-dependent-diabetes mellitus (p = 0.043) and intima-media thickness. In 157 (91.3%) patients intima-media thickening and plaques were present in carotid arteries. We observed high-grade stenosis of carotid arteries in 15 patients (8.7%) with coronary artery disease, furthermore all these patients have had at least two-vessel coronary artery disease.

Conclusions: Alterations within carotid arteries: intia-media thickening and plagues were identified in 91.3% patients. We observed statistically significant correlation between IMT and advancing coronary artery disease. High-grade stenosis of carotid arteries was observed in 8.7% patients with coronary artery disease, furthermore in 13.7% patients with advanced coronary artery disease. IMT increases with age. Hypertension, hyperlipidemia and non-insulin-dependent diabetes mellitus are related to a greater IMT, whereas other risk factors didn't reveal that correlation.