Skip to main content
Clinical Cardiology logoLink to Clinical Cardiology
. 2006 Dec 5;27(11):629–634. doi: 10.1002/clc.4960271110

Relationship of carotid intima‐media thickness, pulse wave velocity, and ankle brachial index to the severity of coronary artery atherosclerosis

Yoshihiro Matsushima 1,, Hiroaki Kawano 1, Yuji Koide 1, Takeshi Baba 1, Genji Toda 1, Shinji Seto 1, Katsusuke Yano 1
PMCID: PMC6654351  PMID: 15562933

Abstract

Background: Carotid intima‐media thickness (IMT), pulse wave velocity (PWV), and the ankle brachial index (ABI) are widely used noninvasive modalities for evaluating atherosclerosis.

Hypothesis: The aim of this study was to determine the relationship of carotid IMT, PWV, and ABI with the severity of coronary artery disease (CAD), expressed as the Gensini score, and the presence of coronary risk factors.

Methods: We examined 205 consecutive patients (mean age 65 ± 12 years) who were clinically suspected of having CAD and were scheduled to undergo coronary angiography. Carotid intima‐media thickness, brachial‐ankle PWV (baPWV), and ABI were measured in all subjects before they underwent coronary angiography.

Results: Of the 205 patients, 124 patients were diagnosed as having CAD based on the presence of > 50% stenosis in a major coronary artery; the remaining 81 patients did not have CAD. A relatively good correlation was obtained between carotid IMT and the Gensini score (R = 0.411, p < 0.0001), whereas baPWV correlated only weakly with the Gensini score (R = 0.203, p = 0.0035), and ABI did not correlate with it. A multiple regression analysis revealed that the Gensini score correlated significantly and independently with age, male gender, and carotid IMT.

Conclusions: Of the three noninvasive methods, carotid IMT may be more useful for determining coronary artery atherosclerosis than baPWV or ABI.

Keywords: atherosclerosis, intima‐media thickness, pulse wave velocity, ankle‐brachial index, coronary artery disease

Full Text

The Full Text of this article is available as a PDF (76.7 KB).

References

  • 1. Pignoli P, Tremoli E, Poli A, Oreste P, Paoletti R: Intimal plus medial thickness of the arterial wall: A direct measurement with ultrasound imaging. Circulation 1986; 74: 1399–1406 [DOI] [PubMed] [Google Scholar]
  • 2. Wofford JL, Kahl FR, Howard GR, McKinney WM, Toole JF, Crouse JR III: Relation of extent of extracranial carotid artery atherosclerosis as measured by B‐mode ultrasound to the extent of coronary atherosclerosis. Arterioscler Thromb 1991; 11: 1786–1794 [DOI] [PubMed] [Google Scholar]
  • 3. Craven TE, Ryu JE, Espeland MA, Kahl FR, McKinney WM, Toole JF, McMahan MR, Thompson CJ, Heiss G, Crouse JR III: Evaluation of the associations between carotid artery atherosclerosis and coronary artery stenosis. A case‐control study. Circulation 1990; 82: 1230–1242 [DOI] [PubMed] [Google Scholar]
  • 4. Bots ML, Hoes AW, Koudstaal PJ, Hofman A, Grobbee DE: Common carotid intima‐media thickness and risk of stroke and myocardial infarction: The Rotterdam Study. Circulation 1997; 96: 1432–1437 [DOI] [PubMed] [Google Scholar]
  • 5. van Popele NM, Grobbee DE, Bots ML, Asmar R, Topouchian J, Reneman RS, Hoeks AP, van der Kuip DA, Hofman A, Witteman JC: Association between arterial stiffness and atherosclerosis: The Rotterdam Study. Stroke 2001; 32: 454–460 [DOI] [PubMed] [Google Scholar]
  • 6. Laurent S, Boutouyrie P, Asmar R, Gautier I, Laloux B, Guize L, Ducimetière P, Benetos A: Aortic stiffness is an independent predictor of all‐cause and cardiovascular mortality in hypertensive patients. Hypertension 2001; 37: 1236–1241 [DOI] [PubMed] [Google Scholar]
  • 7. Yamashina A, Tomiyama H, Takeda K, Tsuda H, Arai T, Hirose K, Koji Y, Hori S, Yamamoto Y: Validity, reproducibility, and clinical significance of noninvasive brachial‐ankle pulse wave velocity measurement. Hypertens Res 2002; 25: 359–364 [DOI] [PubMed] [Google Scholar]
  • 8. Munakata M, Ito N, Nunokawa T, Yoshinaga K: Utility of automated brachial ankle pulse wave velocity measurements in hypertensive patients. Am J Hypertens 2003; 16: 653–657 [DOI] [PubMed] [Google Scholar]
  • 9. Yamashina A, Tomiyama H, Arai T, Hirose K, Koji Y, Hirayama Y, Yamamoto Y, Hori S: Brachial‐ankle pulse wave velocity as a marker of atherosclerotic vascular damage and cardiovascular risk. Hypertens Res 2003; 26: 615–622 [DOI] [PubMed] [Google Scholar]
  • 10. Papamichael CM, Lekakis JP, Stamatelopoulos KS, Papaioannou TG, Alevizaki MK, Cimponeriu AT, Kanakakis JE, Papapanagiotou A, Kalofoutis AT, Stamatelopoulos SF: Ankle‐brachial index as a predictor of the extent of coronary atherosclerosis and cardiovascular events in patients with coronary artery disease. Am J Cardiol 2000; 86: 615–618 [DOI] [PubMed] [Google Scholar]
  • 11. van der Meer IM, Bots ML, Hofman A, del Sol AI, van der Kuip DA, Witteman JC: Predictive value of noninvasive measures of atherosclerosis for incident myocardial infarction: The Rotterdam Study. Circulation 2004; 109: 1089–1094 [DOI] [PubMed] [Google Scholar]
  • 12. Gensini G: Coronary Angiography. Mount Kisco, NY: Blackwell Publishing, Inc., 1975. [Google Scholar]
  • 13. Hulthe J, Wikstrand J, Emanuelsson H, Wiklund O, de Feyter PJ, Wendel‐hag I: Atherosclerotic changes in the carotid artery bulb as measured by B‐mode ultrasound are associated with the extent of coronary atherosclerosis. Stroke 1997; 28: 1189–1194 [DOI] [PubMed] [Google Scholar]
  • 14. Adams MR, Nakagomi A, Keech A, Robinson J, McCredie R, Bailey BP, Freedman SB, Celermajer DS: Carotid intima‐media thickness is only weakly correlated with the extent and severity of coronary artery disease. Circulation 1995; 92: 2127–2134 [DOI] [PubMed] [Google Scholar]
  • 15. Ebrahim S, Papacosta O, Whincup P, Wannamethee G, Walker M, Nicolaides AN, Dhanjil S, Griffin M, Belcaro G, Rumley A, Lowe GD: Carotid plaque, intima media thickness, cardiovascular risk factors, and prevalent cardiovascular disease in men and women: The British Regional Heart Study. Stroke 1999; 30: 841–850 [DOI] [PubMed] [Google Scholar]
  • 16. Bots ML, Evans GW, Riley WA, Grobbee DE: Carotid intima‐media thickness measurements in intervention studies: Design options, progression rates, and sample size considerations: A point of view. Stroke 2003; 34: 2985–2994 [DOI] [PubMed] [Google Scholar]
  • 17. Lehmann ED: Clinical value of aortic pulse‐wave velocity measurement. Lancet 1999; 354: 528–529 [DOI] [PubMed] [Google Scholar]
  • 18. Megnien JL, Simon A, Denarie N, Del‐Pino M, Gariepy J, Segond P, Levenson J: Aortic stiffening does not predict coronary and extracoronary atherosclerosis in asymptomatic men at risk for cardiovascular disease. Am J Hypertens 1998; 11: 293–301 [DOI] [PubMed] [Google Scholar]
  • 19. Vogt MT, McKenna M, Wolfson SK, Kuller LH: The relationship between ankle brachial index, other atherosclerotic disease, diabetes, smoking and mortality in older men and women. Atherosclerosis 1993; 101: 191–202 [DOI] [PubMed] [Google Scholar]
  • 20. Stamler J, Wentworth D, Neaton JD: Is relationship between serum cholesterol and risk of premature death from coronary heart disease continuous and graded? Findings in 356,222 primary screenees of the Multiple Risk Factor Intervention Trial (MRFIT). J Am Med Assoc 1986; 256: 2823–2828 [PubMed] [Google Scholar]
  • 21. Sakaguchi M, Kitagawa K, Nagai Y, Yamagami H, Kondo K, Matsushita K, Oku N, Hougaku H, Ohtsuki T, Masuyama T, Matsumoto M, Hori M: Equivalence of plaque score and intima‐media thickness of carotid ultra‐sonography for predicting severe coronary artery lesion. Ultrasound Med Biol 2003; 29: 367–371 [DOI] [PubMed] [Google Scholar]

Articles from Clinical Cardiology are provided here courtesy of Wiley

RESOURCES