What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Coronary artery disease (n=501). Intervention: Carotid artery intima-media thickness and plaque score. Primary outcome: Intermediate or high SYNTAX score (OR 1.24, p=< 0.0001).

What question did this study set out to answer?

To examine the relationship between carotid ultrasound measurements—specifically intima-media thickness and plaque score—and the complexity of coronary artery disease quantified by the SYNTAX score.

October 25, 2011European Heart Journal

Carotid artery intima-media thickness and plaque score can predict the SYNTAX score

Q: What are the key findings of this study?

Carotid artery mean intima-media thickness and plaque score significantly predicted an intermediate or high SYNTAX score (OR 1.24 and 1.31, respectively).

Q: What question did this study set out to answer?

To examine the relationship between carotid ultrasound measurements—specifically intima-media thickness and plaque score—and the complexity of coronary artery disease quantified by the SYNTAX score.

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Key result

Carotid IMT linked to ~24% higher odds of an intermediate or high SYNTAX score.

OR 1.24
P<0.0001
n=501

Why the study?

Do carotid ultrasound parameters (meanIMT and plaque score) predict the severity of the SYNTAX score in patients undergoing first coronary angiography?

Population

501 consecutive patients who underwent carotid ultrasound and first coronary angiography

Design

Cross-sectional

Authors

NINobutaka IkedaInterventional / Structural Cardiology NKNorihiro KogameInterventional Cardiology RIRaisuke IijimaToho University

Discussion

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Implication

May allow ruling out complex CAD noninvasively; hypothesis-generating and requires prospective validation.

Key Points

To examine the relationship between carotid ultrasound measurements—specifically intima-media thickness and plaque score—and the complexity of coronary artery disease quantified by the SYNTAX score.
Evaluated 501 consecutive patients who underwent carotid ultrasound and their initial coronary angiography between December 2008 and January 2011.
Measured mean common carotid artery intima-media thickness (meanIMT) and plaque score (PS), categorizing SYNTAX scores (SXscore) as low (0–22, 84.8%), intermediate (23–32, 7.4%), or high (≥33, 7.8%).
SXscore positively correlated with meanIMT (Spearman's rank correlation coefficient ρ = 0.442, P < 0.0001) and PS (ρ = 0.544, P < 0.0001).
Odds ratios for predicting intermediate or high SXscores were 1.24 for meanIMT and 1.31 for PS, with areas under the ROC curves of 0.791 and 0.846, respectively.
A meanIMT cutoff of ≥0.9 mm demonstrated 92.1% sensitivity and 97.3% negative predictive value, while a PS cutoff of ≥5 demonstrated 96.1% sensitivity and 98.6% negative predictive value for intermediate or high SXscores.

Study Design

Type

Cross-Sectional (n=501)

Structured PICO

Do carotid ultrasound parameters (meanIMT and plaque score) predict the severity of the SYNTAX score in patients undergoing first coronary angiography?

Population

501 consecutive patients who underwent carotid ultrasound and first coronary angiography to evaluate the relationship between carotid findings and coronary disease complexity.

Exposure

Carotid ultrasound parameters (mean common carotid artery intima-media thickness [meanIMT] and plaque score [PS])

Outcome

Severity of the SYNTAX score (SXscore)surrogate

Main Result

Odds Ratio: 1.24

p-value: p=< 0.0001

Carotid ultrasound parameters, specifically mean intima-media thickness and plaque score, have excellent negative predictive value for ruling out complex coronary artery lesions as assessed by the SYNTAX score.

Cite This Study

Ikeda et al. (2011) conducted a cross-sectional in Coronary artery disease (n=501). Carotid artery intima-media thickness and plaque score was evaluated on Intermediate or high SYNTAX score (OR 1.24, p=< 0.0001). Carotid artery mean intima-media thickness and plaque score significantly predicted an intermediate or high SYNTAX score (OR 1.24 and 1.31, respectively).

synapsesocial.com/papers/6aa3bd6734a74eb94ec7f91f https://doi.org/10.1093/eurheartj/ehr399

Topics

Coronary artery disease

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Carotid artery intima-media thickness and plaque score can predict the SYNTAX score

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Topics

Carotid artery intima-media thickness and plaque score can predict the SYNTAX score

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Also Consider

Topics

Also Consider