Association of CAROTID intima-media thickness with extent of coronary atherosclerosis using duke jeopardy score.

BACKGROUND: Thickening of the carotid intima-media is commonly recognized as the initial stage in the development of atherosclerosis. Measures of common carotid intima-media thickness (CCA-IMT) are directly correlated with severity of coronary artery disease (CAD). In those with known CAD, both CCA-IMT and Duke jeopardy score can be used to stratify patient's prognosis. OBJECTIVE: To examine the association between CCA-IMT measured by B-mode ultrasonography and extent of coronary atherosclerosis based on quantitative coronary angiography using the Duke jeopardy scoring. METHOD: We measured carotid intima-media (IMT) by B mode ultrasonography and angiographic severity of CAD in 400 subjects to assess any relation between IMT and CAD status. For individuals with significant coronary angiographic findings, the severity of CAD was estimated quantitatively by the Duke jeopardy score. RESULTS: Carotid IMT showed significant correlation with the extent of CAD with the Duke jeopardy score (r=0.188, p=<0.001). As a screening test, an IMT cut off value of 0.9mm was able to predict the presence of significant CAD with a sensitivity of 63.61 percent and a specificity of 61.29 percent. The positive predictive value (PPV) of an abnormal scan (IMT > 0.9 mm) for detecting significant CAD was 81.5 percent and a negative predictive value (NPV) of 31.5 percent. CONCLUSION: Ultrasonographically measured far wall CCA-IMT was positively correlated with angiographically determined Duke jeopardy score. The higher the IMT, die more severe is the coronary atherosclerosis.