Sonographic evaluation of carotid intima-media thickness and carotid plaques in coronary artery disease patients

Abstract

Background: Coronary artery disease (CAD) is associated with significant mortality and morbidity. Atherosclerosis is the most common pathophysiology behind this condition. This manifests as an increase in arterial wall intima-media thickness and subsequent plaque formation in the asymptomatic phase. Objectives: To measure the carotid intima-media thickness (CIMT) value of carotid arteries in patients with angiographically diagnosed CAD and also asses the carotids for the presence of plaques and if present to characterize them. Materials and Methods: A total of 100 angiographically diagnosed CAD patients were included in the descriptive study and data were analyzed regarding the increased CIMT, and plaques in the carotid arteries in relation to the corresponding coronary disease. Results: Raised CIMT values were found in 47 out of 100 patients. A linear proportional relationship of mean CIMT values with the number of involved coronary arteries was also observed. A total of 62 plaques were demonstrated in 43 patients. Majority of the plaques (65%) had a smooth surface with uniform outlines. Eighteen plaques were found to have irregular surface outlines (29%), whereas four out of 62 plaques (6%) had ulcerated surfaces. Conclusion: There is increased CIMT prevalence and its linear proportional relationship with an increased number of affected coronary vessels in patients with CAD. Furthermore, an increased prevalence of carotid plaques is present in these patients. Hence, the increased CIMT and the presence of carotid plaques may act as surrogate markers for risk stratification in a patient with CAD.

Keywords

• carotid plaque
• coronary artery disease
• intima-media thickness
• ultrasound