16. Is it Possible to Predict Coronary Artery Stenosis Based on Carotid Artery Intima Media Thickness in Diabetic Patients

Abstract

Background

Noninvasive measurement of carotid artery intima media thickness (IMT) has been widely used as a surrogate marker of coronary atherosclerosis. However, evidence for the clinical implications of increased carotid IMT in diabetic patients is not well established. The aim of this study was to determine if coronary artery disease (CAD) can be predicted based on carotid IMT, intimal, and medial thickness.

Methods

A total of 569 type 2 diabetic patients (male:female = 311:258, mean age = 63 ± 9 years) who underwent coronary angiography were divided into two groups. Group 1 was composed of patients with no significant CAD (n = 105, male% = 37.1%, mean age = 61 ± 10 years) on angiography. Group 2 was composed of patients with significant CAD (n = 464. male% = 58.6%, mean age = 64 ± 9 years). Carotid intimal, medial thickness, and IMT were compared between the two groups. Sensitivity and specificity for detecting significant CAD by carotid ultrasound were evaluated.

Results

There were significant differences in the right maximal IMT, mean IMT, and medial thickness for both carotid arteries. However, there were no significant differences in the left maximal IMT and intimal thickness (Table). A right IMT of 1.13 mm and a left IMT of 1.19 mm had 94% sensitivity and 80% specificity for CAD, respectively. A right medial thickness of 0.99 mm and a left medial thickness of 1.03 mm had 100% sensitivity and 86% specificity.

Conclusion

Carotid medial thickness and IMT were useful as screening methods for detecting significant CAD in patients with diabetes.