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DOI: 10.18413/2313-8955-2017-3-3-41-50

IMPORTANCE OF THE INTIMA MEDIA THICKNESS OF THE COMMON CAROTID ARTERY IN PREDICTION OF ATHEROSCLEROTIC LESIONS OF THE CORONARY VESSELS

Larysa V. Zhuravlyova
Natalia A. Lopina

The purpose of the research was to assess the intima media thickness of the common carotid artery (IMT CCA) in patients with coronary artery disease (CAD), depending on the presence of type 2 diabetes mellitus (T2DM) and the nature of coronary arteries lesions and its value in predicting the presence and the severity of the atherosclerotic lesions of the coronary arteries (CA). Materials and Methods: 131 patients with CAD (89 men, 42 women), mean age of 59.6 ± 9.11 years were examined. Depending on the presence of T2DM, patients with CAD were divided into 2 groups: 1st group (n = 70) – patients with concomitant T2DM, 2nd group (n=61) – patients with CAD without T2DM. Coronarography was performed for all patients to verify the diagnosis of CAD. Also, there were assessed IMT CCA using Doppler ultrasound in all patients. The control group consisted of 20 healthy volunteers of corresponding gender and age.
Results: The study found that patients with CAD both with concomitant T2DM, and with no signs of the disease had increased levels of IMT CCA significantly compared to the control group and the group of comparison (p˂0.05). In persons with hemodynamically significant stenosis of the CA and diffuse damage to the CA with both concomitant DM of type 2 and without type 2 diabetes, the values of IMT CCA were higher than in those without hemodynamically significant CA lesions and diffuse CA lesions, respectively. In our study, the predictive value for the presence of coronary atherosclerosis was set for the value of IMT CCA more than 0.97 mm, the sensitivity and specificity of the method were high and were 89.3% and 100% respectively, the area under the ROC curve (AUC) was 0.979±0.0099 (95% confidence interval: 0.941 to 0.995, p <0.0001). The prognostic significance of determining the value of IMT CCA for the presence of hemodynamically significant stenosis of the CA was set for the value of the IMT CCA more than 0.975 mm, the sensitivity and specificity of the method are 86.7% and 41.5% respectively, the area under the ROC curve (AUC) is 0.584±0,0546 (95% confidence interval: 0.501 to 0.664, p = 0.1239). The prognostic significance of determining the value of IMT CCA for predicting the presence of diffuse coronary artery disease was set for the value of IMT CCA more than 1.035 mm, the sensitivity and specificity of the method are 92% and 39.6% respectively, the area under the ROC curve (AUC) is 0.692±0.0428 (95 % Confidence interval: 0.612 to 0.765, p<0.0001). Conclusions. Determination of IMT CCA is important both in predicting the presence of atherosclerotic lesions of the coronary vessels, and in diagnostics of hemodynamically significant coronary artery stenosis, diffuse coronary lesions.
 

Keywords: intima media thickness of the common carotid artery, coronary atherosclerosis, coronary artery disease, type 2 diabetes mellitus.
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Zhuravlyova LV, Lopina NA. Znachenie tolshchiny kompleksa intima-media sonnykh arteriy v prognozirovanii ateroskleroticheskogo porazheniya koronarnykh sosudov [Importance of the intima media thickness of the common carotid artery in prediction of atherosclerotic lesions of the coronary vessels] // Research Result. Medicine and Pharmacy. 2017;3(3):41-50.

https://doi.org/ 10.18413/2313-8955-2017-3-3-41-50

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