BMC Cardiovascular Disorders (Apr 2025)

Carotid intima thickness and elasticity combined with MHR predicting the severity of coronary artery stenosis in patients with premature coronary artery disease

  • Chenjing Xu,
  • Ming Wu,
  • Xijun Zhang,
  • Kaikai Shen,
  • Yanyan Guo,
  • Jianjun Yuan,
  • Haohui Zhu

DOI
https://doi.org/10.1186/s12872-025-04693-w
Journal volume & issue
Vol. 25, no. 1
pp. 1 – 10

Abstract

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Abstract Background Carotid intima thickness (CIT) and hardness coefficient (HC) are sensitive indicators of structural and functional changes in the carotid arteries in the subclinical stage of atherosclerosis. The monocyte to high-density lipoprotein cholesterol ratio (MHR), which is a biomarker of inflammation, has been shown to correlate with cardiovascular disease. The aim of this study was to assess the predictive value of CIT and HC with MHR in determining the severity of coronary artery stenosis in patients with premature coronary artery disease (PCAD). Methods This prospective study included 85 PCAD patients who underwent coronary angiography. Patients were categorized into high-score (42 cases) and low-score (43 cases) groups based on the median Gensini score. Additionally, 41 volunteers matched by body mass index (BMI), age, and gender served as a control group. CIT, carotid media thickness (CMT) and carotid intima-media thickness (CIMT) were measured using a 24 MHz ultra-high frequency ultrasound probe. Diameter (Diam), distance (Dist), pulse wave velocity (PWV), and HC were evaluated through RF-data based quantitative analysis on vessel stiffness. Binary logistic regression identified risk factors influencing the severity of coronary artery stenosis. Receiver operating characteristic curves were plotted to evaluate the diagnostic performance of CIT, HC, and MHR, both individually and in combination, for predicting coronary artery stenosis severity in PCAD patients. Results CIT, HC and MHR were significantly higher in the high group than in the low and control groups. CIT (AUC = 0.731, 95%CI: 0.624–0.838, P < 0.001) and HC (AUC = 0.783, 95%CI: 0.683–0.882, P < 0.001) individually demonstrated good diagnostic performance in assessing the severity of coronary artery stenosis, with the combined use of carotid parameters and MHR achieving the highest diagnostic efficacy (AUC = 0.849, 95%CI: 0.770–0.929, P < 0.001). Conclusion Patients in the high group had elevated CIT, CIT/CMT, and HC compared to those in the low group. Combining CIT and HC with MHR demonstrated high efficacy in predicting coronary artery stenosis severity in PCAD patients.

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