Association of Carotid Intima Media Thickness with the Extent of Angiographically Proven Coronary Artery Disease
DOI:
https://doi.org/10.51985/Keywords:
Carotid Intima-Media Thickness; Coronary Angiography; Coronary Artery Disease; Gensini Score; Risk Factors; UltrasonographyAbstract
Objective: To evaluate the association between carotid intima-media thickness (CIMT) with the extent of angiographically proven coronary artery disease (CAD).
Study Design and Setting: A cross-sectional study was conducted at Khyber Teaching Hospital (KTH), Peshawar.
Methodology: The study included 65 patients receiving diagnostic coronary angiography and was conducted from 1st April 2025 to 30th September 2025. Cardiovascular risk factors were among the baseline clinical and demographic features that were documented. High-resolution B-mode ultrasonography was used to measure CIMT. The degree of CAD was classified as either no CAD, single-vessel, two-vessel, or three-vessel disease, and its severity was measured using the Gensini score. Regression and correlation models were used to examine relationships between CIMT and angiographic results. The diagnostic accuracy of CIMT for predicting obstructive CAD was assessed using receiver operating characteristic (ROC) curve analysis.
Results: The mean age of participants was 56.2 ± 9.8 years, with 64.6% males. Obstructive CAD was present in 75.4% of patients. CIMT increased progressively with the extent of CAD, from 0.68 ± 0.10 mm in patients without CAD to 1.02 ± 0.13 mm in those with three-vessel disease (p < 0.001). CIMT showed a strong positive correlation with the Gensini score (p < 0.001). ROC analysis demonstrated good diagnostic accuracy (AUC = 0.82).
Conclusion: CIMT is a reliable, non-invasive marker that correlates with the severity of CAD and can aid in early risk stratification and clinical decision-making.
References
1. Kab³ak-Ziembicka A, Przew³ocki T. Clinical Significance of
Carotid Intima-Media Complex and Carotid Plaque Assessment
by Ultrasound for the Prediction of Adverse Cardiovascular
Events in Primary and Secondary Care Patients. J Clin Med.
2021 Oct 9;10(20):4628. Doi: 10.3390/jcm10204628..
2. Polak JF, Backlund JC, Budoff M, Raskin P, Bebu I, Lachin
JM; DCCT/EDIC Research Group. Coronary Artery Disease
Events and Carotid Intima-Media Thickness in Type 1 Diabetes
in the DCCT/EDIC Cohort. J Am Heart Assoc. 2021 Dec
21;10(24):e022922. doi: 10.1161/JAHA.121.022922.
3. Parkkila K, Kiviniemi A, Tulppo M, Perkiömäki J, Kesäniemi
YA, Ukkola O. Abdominal aorta plaques are better in predicting
future cardiovascular events compared to carotid intimamedia thickness: A 20-year prospective study. Atherosclerosis.
2021 Aug;330:36-42. doi: 10.1016/j.atherosclerosis.
2021.06.925.
4. Abeysuriya V, Perera BPR, Wickremasinghe AR. Regional
and demographic variations of Carotid artery Intima and
Media Thickness (CIMT): A Systematic review and metaanalysis. PLoS One. 2022 Jul 12;17(7):e0268716.5. Magri CJ, Xuereb S, Xuereb RA, Xuereb RG, Fava S, Galea
J. Sleep measures and cardiovascular disease in type 2 diabetes
mellitus. Clin Med (Lond). 2023 Jul;23(4):380-386. Doi:
10.7861/clinmed 2022-0442.
6. Ling Y, Wan Y, Barinas-Mitchell E, Fujiyoshi A, Cui H,
Maimaiti A, Xu R, Li J, Suo C, Zaid M. Varying Definitions
of Carotid Intima-Media Thickness and Future Cardiovascular
Disease: A Systematic Review and Meta-Analysis. J Am Heart
Assoc. 2023 Dec 5;12(23):e031217. doi: 10.1161/JAHA.123.
031217.
7. Ge J, Jing F, Ji R, Tian A, Su X, Li W, He G, Pu B, Lei L, Lu
J, Li J. Age-Related Trends in the Predictive Value of Carotid
Intima-Media Thickness for Cardiovascular Death: A
Prospective Population-Based Cohort Study. J Am Heart
Assoc. 2023 Jul 4;12(13):e029656. Doi: 10.1161/JAHA.123.
029656.
8. Muthanna B, Sadangi RK, Hosur B, Jain NK, Monga IS.
Sonographic evaluation of carotid intima-media thickness
and carotid plaques in coronary artery disease patients. Journal
of Marine Medical Society. 2023;25(Suppl 1):S58-S63.
9. Yu B, Wu Y, Li W, Zhou L, Lin Y, Wang W, Li G, Zhou Y,
Hu X, Li X. Predictive effect of different blood lipid parameters
combined with carotid intima-media thickness on coronary
artery disease. Front Cardiovasc Med. 2023 Jan 12;9:1105413.
Doi: 10.3389/fcvm 2022.1105413.
10. Ou Q, Zhang J, Wen X, Yang L, Tao L. Clinical significance
of carotid intima-media thickness and plasma homocysteine
in acute ST-segment elevation myocardial infarction.
Cardiovasc Diagn Ther. 2023 Dec 15;13(6):917-928. doi:
10.21037/cdt-23-312.
11. Liu D, Du C, Shao W, Ma G. Diagnostic Role of Carotid
Intima-Media Thickness for Coronary Artery Disease: A
Meta-Analysis. Biomed Res Int. 2020 Feb 25;2020:9879463.
Doi: 10.1155/2020/9879463.
12. Kim N, Hwang HJ, Yang IH. Assessing Cardiovascular Risk
with Coronary Artery Calcium and Carotid Intima-Media
Thickness in Patients with Negative Stress Echocardiography.
Biomedicines. 2024 Sep 23;12(9):2151. doi: 10.3390/bio
medicines12092151.
13. Cazelli JG, Camargo GC, Kruczan DD, Weksler C, Felipe
AR, Gottlieb I. Prevalence and prediction of obstructive
coronary artery disease in patients undergoing primary heart
valve surgery. Arq Bras Cardiol. 2017;109(4):348–356.
doi:10.5935/abc.20170135.
14. Maia F, Zukowski C, Oliveira M, Peralta D, Beraldo de
Andrade P, Tebet M, Esteves V, Mattos LA, Ferreira E,
Albuquerque DC. Tiger II vs JUdkins Catheters for Transradial
Coronary Angiography (TIJUCA Study): A Randomized
Controlled Trial of Radiation Exposure. J Invasive Cardiol.
2021 Mar;33(3):E200-E205. Epub 2021 Feb 18. PMID:
33600354.
15. Wang KY, Zheng YY, Wu TT, Ma YT, Xie X. Predictive
Value of Gensini Score in the Long-Term Outcomes of Patients
With Coronary Artery Disease Who Underwent PCI. Front
Cardiovasc Med. 2022 Jan 24;8:778615. Doi: 10.3389/fcvm
2021.778615.
16. Verma B, Katyal D. Carotid intima-media thickness predicted
the presence but not the severity or complexity of coronary
artery disease in a South Asian population. Clin Investig
Arterioscler. 2022 Jul-Aug;34(4):183-192. English, Spanish.
Doi: 10.1016/j.arteri.2021.12.001.
17. Heriadi H, Hasballah I, Gani A, Diah M. The Association of
Carotid Intima-Media Thickness with the Severity of Stenosis
Assessed by the Gensini Score in Coronary Artery Disease
Patients. The Association of Carotid Intima-Media Thickness
with the Severity of Stenosis Assessed by the Gensini Score
in Coronary Artery Disease Patients. 2022;109(1):9-.
18. Zhang Z, Gao Y, Li Z, Li B, Gao S, Sun J, Tu J, Ning X,
Zhang W, Wang J. Association of carotid atherosclerotic
plaque and intima-media thickness with the monocyte to highdensity lipoprotein cholesterol ratio among low-income
residents of rural China: a population-based cross-sectional
study. BMC Public Health. 2023 Dec 19;23(1):2541. doi:
10.1186/s12889-023-17447-0.
19. Phair AS. Evaluating imaging biomarkers in the assessment
of carotid disease: The University of Manchester (United
Kingdom); 2023.
20. Zhao M, Zhang L, Chen J, Gu S, Wu R, Jia C. Associations
between carotid plaque shape, biomechanical parameters, and
ischemic stroke in mild carotid stenosis with a single plaque.
Ultrasonography. 2024 May;43(3):209-219. doi: 10.14366/
usg.24019
Downloads
Published
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Journal of Bahria University Medical & Dental College is an open access journal and is licensed under CC BY-NC 4.0. which permits unrestricted non commercial use, distribution and reproduction in any medium, provided the original work is properly cited. To view a copy of this license, visit https://creativecommons.org/licenses/by-nc/4.0
