Coskun Ugur, Yildiz Ahmet, Esen Ozlem B, Baskurt Murat, Cakar Mehmet A, Kilickesmez Kadriye O, Orhan Lutfu A, Yildiz Seyma
Istanbul University, Institute of Cardiology, Haseki, Turkey.
Cardiovasc Ultrasound. 2009 Dec 31;7:59. doi: 10.1186/1476-7120-7-59.
Since cardiovascular diseases are associated with high mortality and generally undiagnosed before the onset of clinical findings, there is a need for a reliable tool for early diagnosis. Carotid intima-media thickness (CIMT) is a non-invasive marker of coronary artery disease (CAD) and is widely used in practice as an inexpensive, reliable, and reproducible method. In the current study, we aimed to investigate prospectively the relationship of CIMT with the presence and extent of significant coronary artery narrowing in patients evaluated by coronary angiography for stable angina pectoris.
One hundred consecutive patients with stable angina pectoris and documented ischemia on a stress test were included in the study. The patients were divided into two groups according to the result of the coronary angiography: group 1 (39 patients) without a noncritical coronary lesion, and group 2 (61 patients) having at least one lesion more than 50% within the main branches of the coronary arteries. All of the patients underwent carotid Doppler ultrasound examination for measurement of the CIMT by a radiologist blinded to the angiographic data.
The mean CIMT was 0.78 +/- 0.21 mm in Group 1, while it was 1.48 +/- 0.28 mm in Group 2 (p = 0.001). The mean CIMT in patients with single vessel disease, multi-vessel disease, and left main coronary artery disease were significantly higher compared to Group 1 (1.2 +/- 0.34 mm, p = 0.02; 1.6 +/- 0.32 mm, p = 0.001; and 1.8 +/- 0.31 mm, p = 0.0001, respectively). Logistic regression analysis identified CIMT (OR 4.3, p < 0.001) and hypertension (OR 2.4, p = 0.04) as the most important factors for predicting CAD.
The findings of this study show that increase in CIMT is associated with the presence and extent of CAD. In conclusion, we demonstrated the usefulness of carotid intima-media thickness in predicting coronary artery disease but large-scale studies are required to define its role in clinical practice.
由于心血管疾病与高死亡率相关，且通常在临床症状出现之前未被诊断出来，因此需要一种可靠的早期诊断工具。颈动脉内膜中层厚度（CIMT）是冠状动脉疾病（CAD）的一种非侵入性标志物，在实践中作为一种廉价、可靠且可重复的方法被广泛应用。在本研究中，我们旨在前瞻性地研究CIMT与因稳定型心绞痛接受冠状动脉造影评估的患者中显著冠状动脉狭窄的存在及程度之间的关系。
本研究纳入了100例连续的稳定型心绞痛患者，且这些患者在负荷试验中有缺血记录。根据冠状动脉造影结果将患者分为两组：第1组（39例患者）无临界冠状动脉病变，第2组（61例患者）在冠状动脉主要分支内有至少一处病变超过50%。所有患者均接受颈动脉多普勒超声检查，由对血管造影数据不知情的放射科医生测量CIMT。
第1组的平均CIMT为0.78±0.21毫米，而第2组为1.48±0.28毫米（p = 0.001）。单支血管病变、多支血管病变和左主干冠状动脉疾病患者的平均CIMT与第1组相比显著更高（分别为1.2±0.34毫米，p = 0.02；1.6±0.32毫米，p = 0.001；1.8±0.31毫米，p = 0.0001）。逻辑回归分析确定CIMT（比值比4.3，p < 0.001）和高血压（比值比2.4，p = 0.04）是预测CAD的最重要因素。
本研究结果表明CIMT的增加与CAD的存在及程度相关。总之，我们证明了颈动脉内膜中层厚度在预测冠状动脉疾病方面的有用性，但需要大规模研究来确定其在临床实践中的作用。
