Key result
The combination of carotid intima thickness, hardness coefficient, and monocyte to high-density lipoprotein cholesterol ratio demonstrated high diagnostic efficacy in predicting the severity of coronary artery stenosis, achieving an AUC of 0.849.
Why the study?
The study was conducted to assess the predictive value of carotid intima thickness, hardness coefficient, and monocyte to high-density lipoprotein cholesterol ratio in determining coronary artery stenosis severity in patients with premature coronary artery disease.
Does the combination of carotid intima thickness, hardness coefficient, and monocyte to high-density lipoprotein cholesterol ratio predict the severity of coronary artery stenosis in patients with premature coronary artery disease?
Observational (n=126)
Blinded to CAG results
No
Does the combination of carotid intima thickness, hardness coefficient, and monocyte to high-density lipoprotein cholesterol ratio predict the severity of coronary artery stenosis in patients with premature coronary artery disease?
Effect estimate: AUC 0.849 (95% CI 0.770-0.929)
p-value: p=<0.001
The combination of carotid intima thickness, hardness coefficient, and monocyte to HDL-C ratio provides a non-invasive and highly efficacious method for predicting the severity of coronary artery stenosis in patients with premature coronary artery disease.
May support non-invasive stenosis prediction in PCAD; leaves open prospective validation before clinical adoption.
BACKGROUND: Carotid intima thickness (CIT) and hardness coefficient (HC) are sensitive indicators of structural and functional changes in the carotid arteries in the subclinical stage of atherosclerosis. The monocyte to high-density lipoprotein cholesterol ratio (MHR), which is a biomarker of inflammation, has been shown to correlate with cardiovascular disease. The aim of this study was to assess the predictive value of CIT and HC with MHR in determining the severity of coronary artery stenosis in patients with premature coronary artery disease (PCAD). METHODS: This prospective study included 85 PCAD patients who underwent coronary angiography. Patients were categorized into high-score (42 cases) and low-score (43 cases) groups based on the median Gensini score. Additionally, 41 volunteers matched by body mass index (BMI), age, and gender served as a control group. CIT, carotid media thickness (CMT) and carotid intima-media thickness (CIMT) were measured using a 24 MHz ultra-high frequency ultrasound probe. Diameter (Diam), distance (Dist), pulse wave velocity (PWV), and HC were evaluated through RF-data based quantitative analysis on vessel stiffness. Binary logistic regression identified risk factors influencing the severity of coronary artery stenosis. Receiver operating characteristic curves were plotted to evaluate the diagnostic performance of CIT, HC, and MHR, both individually and in combination, for predicting coronary artery stenosis severity in PCAD patients. RESULTS: CIT, HC and MHR were significantly higher in the high group than in the low and control groups. CIT (AUC = 0.731, 95%CI: 0.624-0.838, P < 0.001) and HC (AUC = 0.783, 95%CI: 0.683-0.882, P < 0.001) individually demonstrated good diagnostic performance in assessing the severity of coronary artery stenosis, with the combined use of carotid parameters and MHR achieving the highest diagnostic efficacy (AUC = 0.849, 95%CI: 0.770-0.929, P < 0.001). CONCLUSION: Patients in the high group had elevated CIT, CIT/CMT, and HC compared to those in the low group. Combining CIT and HC with MHR demonstrated high efficacy in predicting coronary artery stenosis severity in PCAD patients.
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Xu et al. (2025) conducted an observational in Premature coronary artery disease (n=126). Carotid intima thickness, hardness coefficient, and MHR vs. Low Gensini score and healthy controls was evaluated on Diagnostic efficacy for predicting coronary artery stenosis severity (high Gensini score) (AUC 0.849, 95% CI 0.770-0.929, p=<0.001). The combination of carotid intima thickness, hardness coefficient, and monocyte to high-density lipoprotein cholesterol ratio demonstrated high diagnostic efficacy in predicting the severity of coronary artery stenosis, achieving an AUC of 0.849.
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