Atherosclerotic changes of extracoronary arteries are associated with the extent of coronary atherosclerosis

The aim of the present study was to examine the association between carotid and femoral artery intima media thickness (IMT) and the extent and severit y of coronary artery disease (CAD) as well as the effects of traditional va scular risk factors on the atherosclerotic changes in the carotid and femor al arteries. Two hundred twenty-four patients who underwent coronary angiog raphy for suspected CAD were evaluated by B-mode ultrasound imaging of the common carotid, internal carotid, carotid bifurcation, and femoral artery f or measurement of IMT; traditional vascular risk factors were also evaluate d in these patients. CAD extent was evaluated by the number of diseased ves sels and by Gensini score. Age, male gender, and diabetes were common risk factors for higher CAD extent and higher carotid and femoral IMT. Insulin l evels were correlated with femoral IMT and CAD extent, whereas blood lipids were correlated predominantly with carotid IMT. IMT from carotid and femor al arteries increased significantly with an increase in CAD extent. Using m ultiple stepwise regression analysis, the following parameters were found t o be independent predictors of CAD extent: male gender (p <0.0001), common femoral artery IMT (p = 0.0028), common carotid artery IMT (p = 0.015), age (p = 0.02), diabetes mellitus (p = 0.035), and carotid artery bulb IMT (p = 0.04). Common femoral IMT was the only independent parameter for predicti ng Gensini score (p <0.0001). In conclusion, there are territorial differen ces in the various arterial beds regarding their response to risk factors, Femoral artery and carotid bulb are independent predictors of CAD extent an d the inclusion of these measurements would add information to that provide d by the common carotid artery. (C) 2000 by Excerpta Medica, Inc.