Correlation of Intima-Media Thickness with Coronary Artery Calcium Scoring in Patients with Low and High Cardiovascular Risk Factors

Document Type : Original Article(s)

Authors

1 Assistant Professor of Cardiology, Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Associate Professor of Interventional Cardiology, Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

3 Professor of Radiology, Department of Radiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

4 Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

10.48305/jims.v43.i810.0319

Abstract

Background: Given that calcification is one of the main causes of atherosclerosis and the Carotid Intima-Media Thickness (CIMT) index is also a predictor of the progression of atherosclerosis, the aim of the present study was to compare the mean CIMT based on Coronary Artery Calcium Scoring (CACS) in patients with low and high cardiovascular risk factors.
Methods: The present cross-sectional study was performed on 100 participants without cardiovascular risk factors as the low-risk group and 100 participants with at least three cardiovascular risk factors as the high-risk group. Patients’ demographic data, their cardiovascular risk factors, underlying diseases, clinical presentations, and their medications were recorded. Then, coronary CT angiography findings, CIMT, and CACS values were documented.
Findings: Mean of CACS in the low-risk group was significantly lower than that of the high-risk group (6.18 ± 2.04 vs. 134.16 ± 62.09, P < 0.001). The CIMT value in the high-risk group with a mean of 0.72 ± 0.12 mm was slightly higher than that of the low-risk group with a mean of 0.71 ± 0.06 mm (P > 0.050). In addition, the correlation coefficient of CACS with CIMT was 0.094(P > 0.05) in the low-risk group and was 0.229 (P < 0.05) in the high-risk group.
Conclusion: According to the results of the present study, CIMT and CACS values in low-risk participants were lower than those of high-risk participants. Moreover, a significant direct correlation between CACS and CIMT was observed in high-risk participants. Thus, a direct association between these two factors may help identify individuals at higher risk of adverse cardiovascular events.

Highlights

Alireza Nematollahi: Google Scholar, PubMed

Parvin Bahrami: Google Scholar, PubMed

Amirreza Sajjadieh Khajouei: Google Scholar, PubMed

Atoosa Adibi: Google Scholar, PubMed

Ali Pouriayevali: Google Scholar, PubMed

Keywords

Main Subjects

References

  1. Bonow RO, Mann DL, Zipes DP, Libby P. Braunwald's heart disease e-book: A textbook of cardiovascular medicine. Amsterdam, Netherlands: Elsevier Health Sciences; 2011.
  2. Samady H, Eshtehardi P, McDaniel MC, Suo J, Dhawan SS, Maynard C, et al. Coronary artery wall shear stress is associated with progression and transformation of atherosclerotic plaque and arterial remodeling in patients with coronary artery disease. Circulation 2011; 124(7): 779-88.
  3. Cademartiri F, Maffei E, Palumbo A, Seitun S, Martini C, Tedeschi C, et al. Coronary calcium score and computed tomography coronary angiography in high-risk asymptomatic subjects: assessment of diagnostic accuracy and prevalence of non-obstructive coronary artery disease. Eur Radiol 2010; 20(4): 846-54.
  4. Ueda H, Harimoto K, Tomoyama S, Tamaru H, Miyawaki M, Mitsusada N, Yasuga Y, et al. Relation of cardiovascular risk factors and angina status to obstructive coronary artery disease according to categorical coronary artery calcium score. Heart Vessels 2012; 27(2): 128-34.
  5. Nieman K, Galema TW, Neefjes LA, Weustink AC, Musters P, Moelker AD, et al Comparison of the value of coronary calcium detection to computed tomographic angiography and exercise testing in patients with chest pain. Am J Cardiol 2009; 104(11): 1499-504.
  6. Henneman MM, Schuijf JD, Pundziute G, van Werkhoven JM, van der Wall EE, Jukema JW, et al. Noninvasive evaluation with multislice computed tomography in suspected acute coronary syndrome: plaque morphology on multislice computed tomography versus coronary calcium score. J Am Coll Cardiol 2008; 52(3): 216-22.
  7. Kepez A, Harmanci A, Hazirolan T, Isıldak M, Kocabas U, Ates A, et al. Evaluation of subclinical coronary atherosclerosis in mild asymptomatic primary hyperparathyroidism patients. Int J Cardiovasc Imaging 2009; 25(2): 187-93.
  8. Rosvall M, Janzon L, Berglund G, Engström G, Hedblad B. Incidence of stroke is related to carotid IMT even in the absence of plaque. Atherosclerosis 2005; 179(2): 325-31.
  9. Blacher J, Guerin AP, Pannier B, Marchais SJ, London GM. Arterial calcifications, arterial stiffness, and cardiovascular risk in end-stage renal disease. Hypertension 2001; 38(4): 938-42.
  10. Ekart R, Hojs R, Hojs-Fabjan T, Balon BP. Predictive value of carotid intima media thickness in hemodialysis patients. Artif Organs 2005; 29: 615–9.
  11. Craven TE, Ryu JE, Espeland MA, Kahl FR, McKinney WM, Toole JF, et al. Evaluation of the associations between carotid artery atherosclerosis and coronary artery stenosis. A case-control study. Circulation 1990; 82: 1230–42.
  12. Benedetto FA, Mallamaci F, Tripepi G, Zoccali C. Prognostic value of ultrasonographic measurement of carotid intima media thickness in dialysis patients. J Am Soc Nephrol 2001; 12: 2458–64.
  13. Hyun-Jin K, Hyung-Bok P, Yongsung S, Yoon-Hyeong C, Eui-Seok H, Deok-Kyu C, et al. Comparison of carotid intima–media thickness and coronary artery calcium score for estimating subclinical atherosclerosis in patients with fatty liver disease. Cardiovasc J Afr 2018; 29(2): 93-8.
  14. Lester SJ, Eleid MF, Khandheria BK, Hurst RT. Carotid intima-media thickness and coronary artery calcium score as indications of subclinical atherosclerosis. Mayo Clin Proc 2009; 84(3): 229-33.
  15. Folsom AR, Evans GW, Carr JJ, Stillman AE, Atherosclerosis Risk in Communities(ARIC) Study Investigators. Association of traditional and nontraditional cardiovascular risk factors with coronary artery calcification. Angiology 2004; 55(6): 613-23.
  16. Mazzone T, Meyer PM, Kondos GT, Davidson MH, Feinstein SB, D’Agostino RB, Perez A, Haffner SM. Relationship of traditional and nontraditional cardiovascular risk factors to coronary artery calcium in type 2 diabetes. Diabetes 2007; 56(3): 849-55.
  17. Akram K, O’Donnell RE, King S, Superko HR, Agatston A, Voros S. Influence of symptomatic status on the prevalence of obstructive coronary artery disease in patients with zero calcium score. Atherosclerosis 2009; 203(2): 533-7.
  18. Gottlieb I, Miller JM, Arbab-Zadeh A, Dewey M, Clouse ME, Sara L, Niinuma H, Bush DE, Paul N, Vavere AL, Texter J. The absence of coronary calcification does not exclude obstructive coronary artery disease or the need for revascularization in patients referred for conventional coronary angiography. J Am Coll Cardiol 2010; 55(7): 627-34.
  19. Grandi NC, Breitling LP, Vossen CY, Hahmann H, Wüsten B, März W, et al. Serum vitamin D and risk of secondary cardiovascular disease events in patients with stable coronary heart disease. Am Heart J 2010; 159(6): 1044-51.
  20. Watson KE, Abrolat ML, Malone LL, Hoeg JM, Doherty T, Detrano R, et al. Active serum vitamin D levels are inversely correlated with coronary calcification. Circulation 1997; 96(6): 1755-60.
  21. Sillesen H, Muntendam P, Adourian A, Entrekin R, Garcia M, Falk E, et al. Carotid plaque burden as a measure of subclinical atherosclerosis: comparison with other tests for subclinical arterial disease in the High Risk Plaque BioImage study. JACC Cardiovasc Imaging 2012; 5(7): 681-9.
  22. Cohen GI, Aboufakher R, Bess R, Frank J, Othman M, Doan D, Mesiha N, Rosman HS, Szpunar S. Relationship between carotid disease on ultrasound and coronary disease on CT angiography. JACC Cardiovasc Imaging 2013; 6(11): 1160-7.
  23. Hyun-Jin K, Hyung-Bok P, Yongsung S, Yoon-Hyeong C, Eui-Seok H, Deok-Kyu C, et al. Comparison of carotid intima–media thickness and coronary artery calcium score for estimating subclinical atherosclerosis in patients with fatty liver disease. Cardiovasc J Afr 2018; 29(2): 93-8.
  24. Gardin JM, Bartz TM, Polak JF, O’Leary DH, Wong ND. What do carotid intima-media thickness and plaque add to the prediction of stroke and cardiovascular disease risk in older adults? The cardiovascular health study. J Am Soc Echocardiogr 2014; 27(9): 998-1005.e2.
  25. Gepner AD, Young R, Delaney JA, Tattersall MC, Blaha MJ, Post WS, Gottesman RF, et al. Comparison of coronary artery calcium presence, carotid plaque presence, and carotid intima-media thickness for cardiovascular disease prediction in the Multi-Ethnic Study of Atherosclerosis. Circ Cardiovasc Imaging 2015 ;8(1): e002262.
  26. Folsom AR, Kronmal RA, Detrano RC, O’Leary DH, Bild DE, Bluemke DA, et al. Coronary artery calcification compared with carotid intima-media thickness in the prediction of cardiovascular disease incidence: the Multi-Ethnic Study of Atherosclerosis(MESA). Arch Intern Med 2008; 168(12): 1333-9.
  27. Budoff MJ, Shaw LJ, Liu ST, Weinstein SR, Tseng PH, Flores FR, et al. Long-term prognosis associated with coronary calcification: observations from a registry of 25,253 patients. J Am Coll Cardiol 2007; 49(18): 1860-70.
  28. Arad Y, Goodman KJ, Roth M, Newstein D, Guerci AD. Coronary calcification, coronary disease risk factors, C-reactive protein, and atherosclerotic cardiovascular disease events: the St. Francis Heart Study. J Am Coll Cardiol 2005; 46(1): 158-65.
  29. Detrano R, Guerci AD, Carr JJ, Bild DE, Burke G, Folsom AR, et al. Coronary calcium as a predictor of coronary events in four racial or ethnic groups. N Engl J Med 2008; 358(13): 1336-45.
Journal of Isfahan Medical School
Volume 43, Issue 810
2nd Week, June
May and June 2025
Pages 319-328

Files

History

  • Receive Date: 07 August 2024
  • Accept Date: 11 June 2025

Share

How to cite

Statistics