Carotid intima-media thickness and plaque occurrence in predicting stable angiographic coronary artery disease

Chao-Chien Chang,^1,2 Mei-Ling Chang,² Chi-Hung Huang,² Po-Ching Chou,² Eng-Thiam Ong,² Chih-Hui Chin<sup>2

1</sup>Department of Pharmacology, School of Medicine, Taipei Medical University, ²Division of Cardiology, Department of Internal Medicine, Cathay General Hospital, Taipei, Taiwan

Background: Carotid intima-media thickness (CIMT) and plaque formation have been used as surrogate end-points for evaluating the regression and/or progression of atherosclerotic cardiovascular disease, but their predictive value for stable coronary artery disease (CAD) is inconclusive.
Methods: Carotid ultrasonography was performed in patients who underwent noninvasive multislice computed tomography (MSCT) angiography for CAD suspected, due to chest pain. CIMT and plaque formation on the left and right common carotid arteries (CCAs), carotid bulb (CB), and proximal internal carotid arteries (ICAs) were evaluated, and the relationship between angiographic CAD, CIMT, and plaque formation was determined.
Results: 120 patients (95 male; 25 female), with a mean age ± standard deviation of 61 ± 11 years (range: 35–89 years) were recruited. Because age had a significant impact on CAD (r = 0.191; P = 0.036), CCA plaques (r = 0.368; P = 0.001), ICA plaques (r = 0.334; P = 0.004), and mean CIMT (r = 0.436; P = 0.001), patients were divided into two groups aged <60 years and ≥60 years. In the <60 years group, CIMT-CB was significantly higher in patients with CAD (P = 0.041), while in the ≥60 years group, mean CIMT, CIMT-CCA, and CIMT-CB were significantly higher in patients with CAD (P < 0.05, for each). In both groups, the occurrence of carotid plaques was significantly higher in patients with CAD than in those without CAD (P < 0.007, for each). After controlling for other risk factors, carotid plaques were an independent predictor of CAD in both groups (P < 0.05, for each), while CIMT-CB could independently predict CAD only in patients ≥60 years old (P = 0.031).
Conclusion: Our findings suggest that carotid plaques are a strong predictor of stable CAD. However, CIMT-CB could predict stable CAD only in patients over 60 years of age.

Keywords: carotid plaque, intima-media thickness, coronary artery disease, ultrasonography