Carotis Intima-Media Thickness, Coronary Calcium Score at Different Stages of Coronary Artery Disease

Abstract

Purpose: Coronary Artery Calcium Score (CACS) and Carotid Artery Intima-Media Thickness (CIMT) are surrogate markers for atherosclerosis. CACS is a recognized indicator of coronary artery disease (CAD), but CIMT's role in CAD diagnosis is debated. This study aimed to assess how well CIMT and CACS predict CAD presence and severity as detected by coronary computed tomography angiography (CCTA). Materials and Methods: In the study, 88 participants (57 CAD and 31 controls) underwent coronary angiography and CACS calculation using computerized tomography and CIMT measured according to the guidelines. Patients with CAD were classified by CACT results and further subdivided by CACS into three groups: Group I (<100), Group II (100-300), and Group III (≥300). The relationship between CIMT and CAD groups with zero Agatston scores, as well as the control group, was also examined. Results: The CACS had 82% sensitivity and 100% specificity for predicting CAD, excluding CAD with 75.6% specificity. A CIMT max cut-off of ≥0.78 mm showed 76% sensitivity and 54% specificity for CAD. A CIMT max cut-off of ≥1.03 mm had 93% specificity but only 35% sensitivity, while ≤0.59 mm excluded CAD with 96% specificity but just 10% sensitivity. Patients with CIMT levels between 0.59 mm and 1.03 mm may need further testing to assess CAD risk accurately. Conclusion: The CACS is more sensitive than CIMT in predicting CAD, and CIMT is not helpful when the CACS is zero. Determining an optimal CIMT cutoff for CAD prediction is challenging, and patients with CIMT between 0.59 mm and 1.03 mm may require additional testing.

Keywords

• Carotis Intima Media Thickness
• Coronary Artery Disease
• Coronary artery calcium score
• Agatston Score

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