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

Yıl 2015, Cilt: 42 Sayı: 4, 501 - 505, 08.01.2016

Bircan Alan , Salih Hattapoğlu Abdurrahim Dusak Adem Aktan

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

• Jeevarethinam A, Venuraju S, Weymouth M, et al. Carotid
• intimal thickness and plaque predict prevalence and severity
• of coronary atherosclerosis: a pilot study. Angiology.2015;66:65-69.
• 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.
• 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.
• 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.
• Salonen JT, Salonen R. Ultrasound B-mode imaging in observational studies of atherosclerotic progression. Circulation
• ;87:II56-65.
• Salonen R, Salonen JT. Progression of carotid atherosclerosis
• and its determinants: a population-based ultrasonography study. Atherosclerosis 1990;81:33-40.
• 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.
• Gensini G. A more meaningful scoring system for determining
• the severity of coronary artery disease. Am J Cardiol 1983;51:606.
• 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.
• Ryan TJ, Faxon DP, Gunnar RM, et al. Guidelines for ercutaneous
• 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.
• Lakka TA, Salonen R, Kaplan GA, et al. Blood pressure and the progression of carotid atherosclerosis in middle-agedmen. Hypertension 1999;34:51-56.
• Wagenknecht LE, D’Agostino R Jr, Savage PJ, et al. Duration
• of diabetes and carotid Wall thickness: the insulin resistance atherosclerosis study (IRAS). Stroke 1997;28:999-1005.
• 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.
• 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.
• Hedblad B, Wikstrand J, Janzon L, et al. Low-dose metoprolol
• 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.
• Poredos P. Intima-media thickness: indicator of cardiovascular risk and measure of the extent of atherosclerosis. Vasc Med 2004;9:46-54.
• Depairon M, Tutta P, van Melle G, et al, Darioli R. Reference
• 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.
• 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.
• 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.
• Held C, Hjemdahl P, Eriksson SV, et al. Prognostic implications
• 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.
• 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.
• Doğan İ, Aktop Z, Erdem Z, et al. The angiographic relationship
• between carotid intima-media thickness and the presence of coronary artery disease. Eur J Health Sci 2015;1:20-26.
• Beşir F.H, Yazgan S, Celbek G, et al. Normal values correlates’
• of carotid intima- media thickness and affecting parameters in healthy adults. Anadolu Kardiyol Derg 2012;12:427-433.