Equivalence of plaque score and intima-media thickness of carotid ultrasonography for predicting severe coronary artery lesion

Carotid atherosclerosis appears to be predictive of myocardial infarction. Because several sonographical indices are available for carotid ultrasound (US), we compared "blindly" the potential utilities of those indices for predicting coronary lesions in 270 patients. Carotid atherosclerosis was evaluated by the following four indices: plaque score (PlaS), intima-media thickness (IMT) of common carotid artery (CCA-IMT), IMT of bulb to internal carotid artery (Bulb-ICA-IMT), and combined IMT measurement from all segments. The existence of coronary lesions was diagnosed by > 50% stenosis in diameter in coronary arteries. All indices were associated with coronary lesions independent of risk factors. By receiver-operating characteristic (ROC) curve analyses, ROC areas defined by Bulb-ICA-IMT (0.76 to 0.86), combined IMT (0.76 to 0.86) and PS (0.76 to 0.87) were greater than that defined by CCA-IMT (0.64 to 0.76). In conclusion, PlaS, Bulb-ICA-IMT and combined IMT are equally effective and could be better than CCA-IMT for predicting coronary lesions in a population with cardiovascular risk. (C) 2003 World Federation for Ultrasound in Medicine Biology.