Intima Media Thickness of Carotid and Femoral Artery as predictor of Cardiovascular Events

Objective: To establish the correlation between IMT (presence and severity) of carotid and femoral artery detected on Doppler study and presence of subclinical CAD in asymptomatic patients for early detection of CAD and risk stratification by a non-invasive method. Methodology: This cross-sectional analytic study was conducted in the Cardiology department of Mayo Hospital Lahore for a period of 1 year. One hundred and twenty asymptomatic subjects with and without conventional risk factors for CAD were included The thickness of the intima-media of carotid and the femoral artery was assessed by high-resolution B mode Ultrasonography. The patients enrolled in our study underwent coronary angiography. Data was entered and analyzed through SPSS (Statistical package for social science) version 16. Results: There were a total of 120 patients with a male-to-female ratio of 1.8:1 The mean age of patients was 32.40 ± 10.74 years, minimum age of patients was 20years while the maximum age was 40 years. Most of our patients were overweight, smokers, and had established family history of heart disease. Most of the patients had a single-vessel disease and had severe CAD at the time of presentation. There were 93 patients whose IMT was >0.8 mm. There were 16 patients whose CMIT was <0.8 mm. Sensitivity, specificity, PPV, NPV and diagnostic accuracy of B-mode USG (using CIMT and FA-IMT) were calculated as 85.32%, 72.73%, 96.88%, 33.33% and 84.17% respectively for CMIT. For FA-IMT sensitivity, specify, PPV, NPV and Diagnostic accuracy of B-mode USG was 84.4%, 54.55%, 94.85%, 26.09% and 81.67% respectively. Conclusion: The increased IMT is a predictor of coronary vascular disease, measured non-invasively with B-mode ultrasound. It can be used to predict future cardiovascular events and risk stratification. If patients are diagnosed in the earlier stages then timely treatment can prevent or regress the progression of the disease.