Association of carotid intima–media thickness with coronary artery disease severity using SYNTAX and GENSINI scores in patients undergoing elective coronary angiography

Background: Coronary artery disease (CAD) is a major cause of global mortality. Diabetes impacts cardiac function even in the absence of hypertension or CAD. The carotid arteries are a primary site for atherosclerosis, and carotid intima–media thickness (CIMT) measurement via ultrasonography aids in early detection. CIMT is a cost-effective, noninvasive marker correlated with CAD severity, with ultrasonographic carotid duplex scanning demonstrating high sensitivity (99%) and specificity (84%). CAD severity, assessed using SYNTAX and GENSINI scores, is linked to cardiovascular risk. Objectives: This study aimed to assess the relationship between CIMT and CAD severity using SYNTAX and GENSINI scores. Secondary objectives included evaluating CIMT’s association with hypertension, diabetes, dyslipidemia, smoking, alcohol use, obesity, and family history of CAD and stroke. Methodology: A prospective, single-center observational study included 150 CAD patients undergoing coronary angiography. CIMT was measured through ultrasonography, and CAD severity was assessed using SYNTAX and GENSINI scores. Statistical correlations were analyzed. Results: Patients with significant CAD had higher mean right CIMT (0.80 ± 0.16 mm) and left CIMT than controls ( P < 0.001). CIMT was significantly associated with CAD severity ( P = 0.001), but correlations with SYNTAX and GENSINI scores were inconsistent. Patients with CIMT >0.9 mm had higher SYNTAX scores, indicating complex CAD. Conclusion: In North Indian CAD patients (74% male, mean age 57.96 years), hypertension was the most common comorbidity. CIMT significantly correlated with stenosis severity, highlighting its predictive value. Larger studies are needed to validate these findings and explore prevention strategies.