Usefulness of carotid intima-media thickness measurement and peripheral B-mode ultrasound scan in the clinical screening of patients with coronary artery disease

Previous observational studies have shown a relationship between carotid in tima-media thickness (IMT) and coronary artery disease (CAD). In this study the authors evaluated the accuracy of the common carotid IMT measurement i n predicting the presence and severity of CAD and the additional informatio n offered by the detection of carotid, iliac, and lower limb plaques. One h undred and fifty consecutive patients were subjected to coronary angiograph y and carotid, iliac, and lower limb ultrasound scan. The mean value of six IMT measurements of the far wall of the common carotid artery was calculat ed in each patient. The mean IMT was significantly correlated to the number of stenosed coronary vessels (r = 0.43, p < 0.001), although the positive and negative predictive value of mean IMT in identifying patients with CAD was low (81% and 46%, respectively). The combined information offered by IM T measurements and peripheral (carotid, iliac, and lower limb) plaque detec t:ion was then used to obtain the best multivariate regression model able t o predict CAD status. The multivariate model showed a highly significant mu ltiple correlation coefficient (r = 0.60, p < 0.0001) and a sharp improveme nt in the negative predictive value (92%) with respect to the univariable m odel. B-mode ultrasound scan including common carotid IMT measurement and p eripheral plaque detection may be of clinical value in the screening of pat ients with CAD.