Usefulness of sum of the thickness of plaque in the carotid artery for predicting the presence and the extent of the coronary artery disease in patients with type 2 diabetes mellitus without known coronary artery disease

Aims: The usefulness of the sum of plaque thickness in the carotid artery (plaque score; PS), as a prediction of coronary artery disease (CAD) was investigated in patients with type 2 diabetes mellitus. Methods: B mode ultrasonographic scanning of the carotid artery and multislice computed tomography (MSCT) coronary angiography were performed in 227 diabetic patients without known cardiac disease. Results: The PS was useful to predict the presence of diseased [nonobstructive and obstructive] CAD (>= 3 segments) and obstructive (>= 50%) CAD with cut-off value of 3.5 mm (area under curve: 0.745 and 0.782, respectively), according to a receiver operating characteristics curve analysis. A multivariate logistic analysis of baseline risk factors showed that the PS was independent risk factor for the prediction of diseased and obstructive coronary artery disease (R-2 = 0.2165, p < 0.0001 and R-2 = 0.2265, p < 0.0001, respectively). The PS was most significant predictor of the number of diseased and obstructive segments of the coronary artery in a multiple regression analysis (R-2 = 0.2022, p < 0.0001 and R-2 = 0.2209, p < 0.0001, respectively). Conclusions: The PS in the carotid artery was useful for the prediction of the presence and the extent of CAD, and was most important as a screening test for the identification of a high risk group of asymptomatic diabetic patients. (C) 2011 Elsevier Ireland Ltd. All rights reserved.