Abstract
We studied the relationship between carotid atherosclerosis and coronary artery disease in 131 subjects with diabetes mellitus undergoing multislice computed tomography (MSCT) coronary angiography. Carotid atherosclerosis was evaluated based on intima-media complex thickness (IMT) in the common carotid artery and plaque score (PS), defined as the sum of maximum thickness of all plaque observed in the bilateral carotid artery. IMT and PS were significantly higher in subjects with significant (≥50%) coronary artery disease (CAD) than in those without. Logistic regression analysis of significant CAD showed PS to be a significant independent variable. The receiver operating characteristic for IMT and PS use in predicting significant CAD showed sensitivity of 59% and specificity of 60% in IMT for a cutoff of 0.888 mm. Sensitivity was 74% and specificity 70% for PS for a cutoff of 3.6 mm.
The number of significant (≥50%) stenotic segments correlated significantly with IMT (r=0.252, p<0.01) and PS (r=0.391, p<0.01). Multiple regression analysis showed PS and LDL-C to be significantly associated with the number of significant (≥50%) stenotic segments in the coronary artery (R2=0.205, p<0.001). The proportion of plaque type in the carotid artery was 3.1% in hypoechoic lesions, 20.8% in isoechoic lesions, 20.5% in hyperechoic lesions, and 55.6% in heterogenous (mixed) lesions. The proportion of plaque type in the coronary artery was 35.2% in noncalcified lesions, 30.4% in calcified lesions, and 34.4% in mixed lesions. The plaque type in the carotid and coronary arteries was similar in 24% of subjects.
These results indicate that PS was more useful than IMT in identifying significant coronary artery disease. PS was also independently associated with coronary artery disease, together with such conventional risk factors as hyperlipidemia.
