Intima-Media Thickness Measurements in the Carotid and Femoral Artery as an Indicator of Symptomatic Coronary Atherosclerosis

Background: Ultrasonographically determined intima-media thickness of peripheral arteries is frequently used as an indicator of generalized and coronary atherosclerosis. Generally, the carotid artery is used. Measurements in the femoral artery have received little attention. Objective: In this study we investigated which of the ultrasonographically determined intima-media thickness measurements in either the common carotid artery, the carotid bulb, the common femoral artery or the superficial femoral artery is the best indicator for clinical coronary atherosclerosis. Methods: We determined the intima-media thickness in the common carotid artery, the carotid bulb, the common femoral artery and in the superficial femoral artery by B-mode ultrasonography in 78 patients with clinically proven severe coronary atherosclerosis and in 47 age-matched population controls. The odds ratio for the presence of coronary atherosclerosis was determined for every quintile of the intima-media thickness measurements in the arteries. Furthermore receiver operating characteristic (ROC) curves were constructed for the arteries to visualize the discriminating power of the measurements in these arteries. Results: For every quintile, the odds ratios (for the presence of clinical coronary atherosclerosis) of the measurements were the highest in the carotid bulb (range 3.7–7.1) and in particular in the common femoral artery (9.8–27.9). Inspection of the ROC curves showed that the test performance (i.e. sensitivity and specificity) to discriminate between individuals with clinical coronary atherosclerosis and the population controls was best for the femoral artery. The curves of the other three arteries were similar. Conclusion: The results of our study indicate that intima-media thickness measurements in the common femoral artery are a better indicator of coronary atherosclerosis than in the other three arteries.