Key result
Elevated carotid IMT plus low ABI linked to ~5-point higher median SYNTAX scores.
Why the study?
The relationship between carotid artery ultrasound findings, ankle-brachial index, and the complexity of coronary artery disease measured by SYNTAX score was unclear.
Are carotid ultrasound findings and ankle-brachial index associated with the complexity of coronary artery disease measured by SYNTAX score?
Cross-Sectional (n=496)
Double-blind (investigators blinded to counterpart testing data)
No
Are carotid ultrasound findings and ankle-brachial index associated with the complexity of coronary artery disease measured by SYNTAX score?
The combination of carotid ultrasound and ankle-brachial index provides useful non-invasive information for predicting the complexity and presence of coronary artery disease.
Combined high IMT and low ABI was associated with greater CAD complexity; leaves open whether noninvasive screening refines SYNTAX-based risk stratification.
BACKGROUND Numerous reports have shown that both carotid artery ultrasound (carotid US) findings and ankle-brachial index (ABI) are associated with the prevalence of coronary artery disease. The relationship between carotid US findings and ABI and the complexity of coronary artery disease (as measured by SYNTAX [SX] score), was evaluated. METHODS AND RESULTS The subjects included 496 consecutive patients who underwent carotid US, ABI analysis and initial coronary angiography. The mean common carotid artery intima-media thickness (mean IMT) was evaluated on carotid US. Patients with mean IMT ≥ 0.9 mm had significantly higher SX scores than patients without thickening (mean IMT <0.9 mm; P<0.0001). Similarly, patients with low ABI (<0.9) had significantly higher SX scores than patients with ABI ≥ 0.9 (P<0.0001). When the patients were divided into 4 groups on the basis of mean IMT and ABI (group A, mean IMT <0.9 mm, ABI ≥ 0.9; group B, mean IMT <0.9 mm, low ABI; group C, mean IMT ≥ 0.9 mm, ABI ≥ 0.9; group D, mean IMT ≥ 0.9 mm, low ABI), the SX scores were significantly different. Among the patients in group D, 75% had coronary artery disease. CONCLUSIONS Carotid US and ABI are associated with SX score. The combination of carotid US and ABI provides useful information for predicting the complexity and presence of coronary artery disease.
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Ikeda et al. (2012) conducted a cross-sectional in Coronary artery disease (n=496). Increased mean intima-media thickness (≥0.9 mm) and low ankle-brachial index (<0.9) vs. Normal intima-media thickness (<0.9 mm) and normal ankle-brachial index (≥0.9) was evaluated on SYNTAX (SX) score representing coronary lesion complexity (p=<0.0001). Patients with a mean intima-media thickness ≥0.9 mm and a low ankle-brachial index (<0.9) had significantly higher median SYNTAX scores (P<0.0001), predicting greater complexity of coronary artery disease.
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