Correlation between Carotid Intima-Media Thickness and Coronary Artery Disease in Patients Evaluated by Coronary Computed Tomography Angiography

Background: The carotid intima-media thickness (CIMT) is increasingly used as surrogate marker for atherosclerosis worldwide. It can be measured simply, noninvasively, and reproducibly by ultrasound. Although CIMT has been considered a tool to improve the estimation of coronary artery atherosclerosis, this application is still a matter of debate and remains unclear whether routine CIMT measurement is useful for the detection of subclinical atherosclerosis in clinical practice in addition there are racial/ethnic differences as many studies have been conducted and revealed different CIMT among various ethnicities or races, leading to a different incidence of (CAD).

Aim: The purpose of this study was to evaluate the correlation between CIMT by ultrasound and atherosclerotic CAD among Iraqi patients and to determine whether increased CIMT is predictive of the presence and severity of coronary atherosclerosis.

Patients and Methods: Carotid ultrasound was carried out on patients who had undergone coronary CT angiography (CCTA) due to suspected coronary artery disease (CAD). To explore the link between carotid IMT and CAD, measurements were taken from three segments on both the right and left common carotid arteries, as well as from the proximal part of the internal carotid arteries.

Result: Among 100 patients (52 men and 48 women) with a mean age (54+10), significant correlation was found between increased CIMT and coronary artery atherosclerosis burden including the calcium score, coronary artery plaque and the presence of significant stenosis. The validity criteria of right and left common carotid arteries intima-media thickness at a cut-off value 0.72 mm and AUC=0.77, revealed relatively high sensitivity (83%) but low specificity (48%). Additionally, a relatively higher AUC=0.82 was obtained from the right-side internal carotid at cut-off value 0.75mm, sensitivity (90%) and specificity (40%).

Conclusion: Carotid intima-media thickness is a sensitive predictor of coronary atherosclerosis detected in symptomatic intermediate-risk patients.