A study to find the usefulness of carotid intima-media thickness in assessing the severity of coronary artery disease and its correlation with coronary angiogram

Introduction: CAD, which was once considered the disease of the west, is now one of the leading causes of death in middle-income countries like India. It has indeed reached epidemic proportion in India. CIMT measurement directly correlates with the pathology, parallels the significance of traditional risk factors and indicates the thickness of the arterial wall making it the preferred noninvasive technique for assessing atherosclerosis. Aim: To study the Usefulness of Carotid Intima-Media Thickness in assessing the severity of Coronary Artery Disease and its correlation with Coronary Angiogram. Materials and methods: 75 patients diagnosed to have CAD in the previous one month and have undergone CAG have been included in the study. Patients were subjected to various symptom analysis, clinical examination, laboratory investigations and CIMT measurement by B mode ultrasound technique using a 10 MHZ probe. Patients were grouped into normal and increased CIMT groups with reference to 0.90 mm. The severity of disease was compared in terms of a nonobstructive CAD, SVD, DVD, TVD, and CAG severity was calculated by the modified Gensini score. The relation between IMT and severity of CAD was determined. Results: The modified Gensini levels in normal CIMT group were meaningfully less than increased CIMT group by 1.55 times with a mean difference of 11.31 points. The CAG findings with triple vessel disease in normal CIMT group were only 16.33%, when compared to increased CIMT group where its occurrence is 53.85%. There was meaningfully a real increase in the risk of developing triple vessel disease with increased CIMT. The CAG findings in normal CIMT group was predominantly normal (34.69%) when compared to increased CIMT group where in it was triple vessel disease (53.85%) with a ‘p' value of 0.0263. Conclusion: CIMT correlates significantly with the severity of coronary artery disease. CIMT > 0.90 mm correlates to advancing CAD. Hence CIMT is a useful atherosclerosis progression marker which when employed in an asymptomatic at-risk individual will definitely decrease disease morbidity if intervened appropriately.