Tariq Hussien, Alrahomi
(2008)
The association of the
intima-media thickness of
common carotid artery
with coronary artery
disease.
Masters thesis, Pusat Pengajian Sains Perubatan.
Abstract
Topic: The association between intima-media thickness of the common carotid artery
with coronary artery disease.
Background: Coronary artery disease (CAD) occurs due to coronary artery stenosis
secondary to atherosclerosis. CAD presents differently ranges from silent preclinical
stage to sudden acute myocardial infraction or sudden death. CAD is one of the most
common diseases in the world and in Malaysia it is considered the number one killer.
Common carotid arteries provide a 11window" to the coronary arteries as both have similar
risk factors. Thus, carotid atherosclerosis provide a window to the degree of coronary
atherosclerosis in an individual by examining the carotid artery wall using a highresolution
B-mode ultrasound transducer to measure the carotid IMT (CIMT).
Objecth'es: 1- To demonstrate if there is any association between the increase in the
CIMT and CAD. 2. To study whether CIMT can be used as a surrogate marker of CAD.
Methodology: High resolution B mode ultrasound examination of both common carotid
arteries was performed on 113 male patients with suspected CAD. CIMT were measured
thre~ times from the distal I em of each common carotid artery. Thereafter, the coronary
angiography was done on the next day. Data about the traditional risk factors of CAD as
age, body mass index (BMI), hypertension, diabetes mellitus, hyperlipidaemia and
smoking were collected.
XVI
Results: It was found that CIMT was significantly higher in patients with CAD
confirmed angiographically than in patients with normal coronary arteries (p~value <
0.001) and CIMT values were higher in patients with advanced CAD (three vessels CAD
compared with one and two vessels CAD) (p-value < 0.001). The mean CIMT in patients
without CAD was 0.72mm, in one vessel CAD was 0.87mm, in two vessels CAD was
0.93 mm and in three vessels CAD was l.lmm. The sensitivity and specificity ofCIMT
were 81.3% and 81.8% respectively while PPV and NPV came out to be 94.9% and
51.5% respectively. In this study, the cardiovascular risk factors and their relation to
CAD and CIMT revealed a significant association between age, smoking, DM and
hyperlipidaemia with CAD and significant association was found between age, smoking
and DM with increased CIMT (with p~value < 0.05).
Conclusion: The results of this study demonstrated that CIMT was significantly higher
in patients with CAD especially in patients with advanced CAD. High resolution B~mode
ultrasound measurement of CIMT can be used clinically as screening tool for early
detection of patients with suspected CAD with no history of myocardial infarction or
patients who are free of symptoms but with a number of cardiovascular risk factors.
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