Relationship of intima-media thickness with Gensini score that determines the severity of coronary artery disease

Öz

Objective: In this study we aimed to compare carotid intima-media thickness (CIMT) with Gensini score which objective evidence to demonstrate the severity of coronary artery disease.

Methods: The study included 76 CAD patients (41 men, 35 women, mean age 60.7±11.2 years, range: 42-83) We calculated the Gensini score and measured CIMT for each patient, CAD patients was separated into two groups: patients with mild atherosclerosis (Gensini score <25 points) and severe atherosclerosis (Gensini score ≥25 points). The CIMT values were compared to Gensini score (CAD severity).

Results: The severe atherosclerosis group had significantly higher CIMT values compared to the mild atherosclerosis group [(1.2±0.16 range: 0.90-1.50), (0.97±0.07 range: 0.90-1.10), p<0.01, respectively].

There was a significant correlation with CIMT and Gensini score, age, BMI, LDL cholesterol [(r= 0.365, p<0.01), (r=0.327, p=0.03), (r=-0.341, p<0.01), (r=0.385, p<0.01), respectively.

Conclusion: We found a significant association between CIMT and Gensini score which objective evidence to severity of CAD. As a non-invasive measurement CIMT can be used as an additional method in recognition of severe coronary artery disease

Key words: Carotid intima-media thickness, Gensini score, coronary artery disease, ultrasonography

Anahtar Kelimeler

• Karotis intima media kalınlığı, gensini skoru, koroner arter hastalığı, ultrasonografi

Kaynakça

1. Jeevarethinam A, Venuraju S, Weymouth M, et al. Carotid
2. intimal thickness and plaque predict prevalence and severity
3. of coronary atherosclerosis: a pilot study. Angiology.2015;66:65-69.
4. Bartman W, Pierzchała K. Clinical determinants of carotid intima-media thickness in patients with diabetes mellitus type 2. Neurol Neurochir Pol 2012;46:519-528.
5. Greenland P, Abrams J, Aurigemma GP, et al. Prevention conference V: beyond secondary prevention; identifying the high-risk patient for primary prevention, noninvasive tests of atherosclerotic burden–writing group III. Circulation 2000;101:16-22.
6. Chambless LE, Heiss G, Folsom AR, et al. Association of coronary heart disease incidence with carotid arterial wall thickness and major risk factors: the atherosclerosis risk in communities (ARIC) study, 1987-1993. Am J Epidemiol 1997;146:483-494.
7. Salonen JT, Salonen R. Ultrasound B-mode imaging in observational studies of atherosclerotic progression. Circulation
8. ;87:II56-65.

9. Salonen R, Salonen JT. Progression of carotid atherosclerosis
10. and its determinants: a population-based ultrasonography study. Atherosclerosis 1990;81:33-40.
11. O’Leary DH, Polak JF, Kronmal RA, et al. Carotid-artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults: cardiovascular health study collaborative research group. N Engl J Med 1999;340:14-22.
12. Gensini G. A more meaningful scoring system for determining
13. the severity of coronary artery disease. Am J Cardiol 1983;51:606.
14. Homma S, Hirose N, Ishida H, Ishii T, Araki G. Carotid plaque and intima-media thickness assessed by B-mode ultrasonography in subjects ranging from young adults to centenarians. Stroke 2001;32:830-835.
15. Ryan TJ, Faxon DP, Gunnar RM, et al. Guidelines for ercutaneous
16. transluminal coronary angioplasty. A report of the American College of Cardiology/American Heart Association Task Force on Assessment of Diagnostic and Therapeutic Cardiovascular Procedures Subcommittee on Percutaneous Transluminal Coronary Angioplasty). Circulation 1988;78:486-502.
17. Lakka TA, Salonen R, Kaplan GA, et al. Blood pressure and the progression of carotid atherosclerosis in middle-agedmen. Hypertension 1999;34:51-56.
18. Wagenknecht LE, D’Agostino R Jr, Savage PJ, et al. Duration
19. of diabetes and carotid Wall thickness: the insulin resistance atherosclerosis study (IRAS). Stroke 1997;28:999-1005.
20. Diez-Roux AV, Nieto FJ, Comstock GW, et al. The relationship of active and passive smoking to carotid atherosclerosis 12-14 years later. Prev Med 1995;24:48-55.
21. Güneş F, Asik M, Altun B, et al. Carotid intima-media thickness and neutrophils/lymphocytes ratio in patients with overt and subclinical hypothyroidism. J Clin Exp Invest 2013;4:463-467.
22. Hedblad B, Wikstrand J, Janzon L, et al. Low-dose metoprolol
23. CR/XL and fluvastatin slow progression of carotid intima-media thickness: main results from the beta-blocker cholesterol-lowering asymptomatic plaque study (BCAPS). Circulation 2001;103:1721-1726.
24. Poredos P. Intima-media thickness: indicator of cardiovascular risk and measure of the extent of atherosclerosis. Vasc Med 2004;9:46-54.
25. Depairon M, Tutta P, van Melle G, et al, Darioli R. Reference
26. values of intima-medial thickness of carotid and femoral arteries in subjects aged 20 to 60 years and without cardiovascular risk factors. Arch Mal Coeur Vaiss 2000;93:721-776.
27. Lim TK, Lim E, Dwivedi G, et al. Normal value of carotid intima-media thickness-a surrogate marker of atherosclerosis:quantitative assessment by B-mode carotid ultrasound. J Am Soc Echocardiogr 2008;21:112-116.
28. Bobryshev YV, Killingsworth MC, Lord RS, et al. Matrix vesicles in the fibrous cap of atherosclerotic plaque: possible contribution toplaque rupture. J Cell Mol Med.2008;12:2073-2082.
29. Held C, Hjemdahl P, Eriksson SV, et al. Prognostic implications
30. of intima-media thickness and plaques in the carotid and femoral arteries in patients with stable angina pectoris. Eur Heart J 2001;22:62-72.
31. Kavak V, Arıtürk Z, İltümür K, et al. Compare of structural and functional changes in athletes, hypertensive patients and healthy sedentary control subjects. Dicle Med J 2006;33:139-144.
32. Doğan İ, Aktop Z, Erdem Z, et al. The angiographic relationship
33. between carotid intima-media thickness and the presence of coronary artery disease. Eur J Health Sci 2015;1:20-26.
34. Beşir F.H, Yazgan S, Celbek G, et al. Normal values correlates’
35. of carotid intima- media thickness and affecting parameters in healthy adults. Anadolu Kardiyol Derg 2012;12:427-433.