The use of ultrasound derived carotid measurements and plaque volume to predict coronary artery disease

Abstract

Introduction
Increased carotid intima-media thickness (cIMT) has been extensively evaluated as a cardiovascular (CV) risk marker. However, other ultrasound (US) measurements such as Lumen Diameter (cLD), interadventica Diameter (cIAD), full-Diameter (cFD) along with plaque volume (TPV) have limited or no research. This study explored the value of these carotid measurements to predict the presence of coronary artery disease (CAD).

Methods
300 patients (67.7% male) undergoing either Invasive Coronary Angiogram (ICA) or Computed Tomography Coronary Angiography (CTCA) with a history of ischaemic-type chest pain or angina were recruited for this study. All patients underwent carotid artery B Mode US imaging to measure cIMT, cIAD, cLD, cFD, TPV and Maximum Area Reduction (MAR). Univariate and multivariate binary logistic regression analysis was used.

Results
Mean age was 63.74±12.35SD years (range, 32-90 years). CV risk factors included family history of CAD (70.8%), current or ex-smoker (54%), hypertension (61%), a history of hyperlipidaemia (67.4%) and diabetes (19.6%). On ICA or CTCA, 233 (77.4%) of patients had a degree of CAD, with 175 (58.1%) as severe CAD (defined as at least 70% area stenosis or pressure wire positive) in at least one coronary artery. cIMT predicted CAD (85.2% vs 32.6%; relative risk [RR] 2.61; p

Conclusion
In this sample of patients with ischaemic type chest pain or angina equivalent symptoms, elevated cIMT, cIAD, cLD, cFD, and TPV all predict CAD, with cIMT accurately predicting 90.12% of all cases of CAD and being an independent predictor.

Date of Award	Dec 2022
Original language	English
Sponsors	Southern Health and Social Care Trust
Supervisor	Jim McLaughlin (Supervisor) & Ian Menown (Supervisor)