European Journal of Biomedical and Pharmaceutical Sciences

A STUDY OF RELATIONSHIP BETWEEN CAROTID INTIMA MEDIAL THICKNESS AND SYNTAX SCORE

Kumar Sankar Poddar*, Santanu De, Shivesh Shanker Sahai, Manoranjan Mandal, Sahid Imam Mallick, Swapan Kumar Halder and Kajal Ganguly

ABSTRACT

Background: Carotid intima medial thickness (CIMT) is a well known surrogate marker of atherosclerotic burden and cardiovascular disease risk. CIMT has been reported to correlate with the extent of atherosclerotic lesions in the coronary arteries. The SYNTAX score is an angiographic tool for grading coronary lesion complexity and is also used as a predictor of clinical outcomes in patients with single or multivessel coronary artery disease. Hence, patients with increased CIMT might have more complex coronary artery disease anatomy as assessed by SYNTAX Score. Objectives: The main purpose of this study was to investigate whether any relationship existed between CIMT and coronary artery disease complexity as assessed by SYNTAX score among Indian coronary artery disease patients. Method: 100 consecutive patients (male 61, female 39; median age 59.4 years ± 9.5) who underwent coronary angiography for the first time based on clinical indication for chronic stable angina or acute coronary syndrome were taken up for CIMT assessment. The SYNTAX scores were assessed by two cardiologists by using the algorithm available on the SYNTAX website. The CIMT values of the right and left sides were measured at 3 segments: the distal common carotid (1 cm proximal to dilation of the carotid bulb), the carotid artery bifurcation (1 cm proximal to the flow divider) and the proximal internal carotid artery (1 cm section of the internal carotid artery immediately distal to the flow divider). At each of these 3 segments, 5 measurements of the far wall were done and the mean CIMT of the right and left carotid arteries were calculated. The presence of carotid plaques if any was also noted. Results: In our study group of 100 subjects, the average SYNTAX score was 14.27 ± 10.25, whereas the mean CIMT (taking the higher value of left and right side) was 0.96 mm ± 0.28 mm. Running a regression analysis we could demonstrate a statistically significant association between CIMT and SYNTAX score (P-value = 0.0112). We also found a statistically significant association between the presence of plaques in the carotid arteries and SYNTAX score (P-value = 0.027). By regression analysis we also found statistically significant correlation between SYNTAX score and diabetes mellitus (P-value = 0.006) and smoking (P-value = 0.034). Conclusion(s): Our study showed a statistical significant association between CIMT and SYNTAX score. From a clinical point of view, results from our study indicate that patients with higher CIMT values may have more complex coronary artery lesions and CIMT may be considered a reliable parameter to predict the SYNTAX score among Indian coronary artery disease patients.

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