[Diagnostic accuracy of carotid ultrasonography in screening for coronary artery disease].
OBJECTIVE
This study investigated the diagnostic accuracy of carotid ultrasonography in screening for significant coronary artery disease (% diameter stenosis > or = 75%).


METHODS
Five hundred sixty patients (342 males, 218 females, mean age 66.4 years) underwent both coronary angiography and carotid ultrasonography. Gensini's coronary score was calculated as a quantitative parameter of coronary atherosclerosis. The most hypertrophic intimal-medial complex thickness (IMT) of the bilateral common carotid arteries (distal and proximal to the echo probe in each artery) was measured within 2 or 3 cm from the carotid bifurcation. The mean IMT (mean of these 4 sites), the maximum IMT (maximum of these 4 sites), and number of plaques (localized hypertrophy of IMT > or = 1.1 mm) were calculated as a quantitative parameter of carotid atherosclerosis.


RESULTS
The screening parameters were determined as 0.85 mm mean IMT, 1.1 mm maximum IMT, and at least 2 sites of plaque. The sensitivity, specificity and accuracy rate for the detection of coronary artery disease were 57.3%, 61.6% and 59.6% for mean IMT, 43.5%, 71.1% and 58.6% for maximum IMT, and 60.8%, 70.5% and 66.1% for number of plaques. Furthermore, the overall results (except maximum IMT) were 73.3%, 49.2% and 60.2%.


CONCLUSIONS
These results suggest that carotid ultrasonography is useful as a non-invasive and easy screening method for coronary artery disease. Furthermore, carotid ultrasonography will allow routine observations to follow the progression of coronary atherosclerosis.
Kawasaki
T
T
Cardiovascular Center, Shin-Koga Hospital, Fukuoka.
Koga
N
N
Hikichi
Y
Y
Otsubo
Y
Y
Kondo
K
K
Shiraishi
T
T
Watanabe
T
T
Higashikata
T
T
Akiyoshi
S
S
Kurashige
Y
Y
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging*; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017539:Tunica Intima / Q000000981:diagnostic imaging; D017540:Tunica Media / Q000000981:diagnostic imaging; D014463:Ultrasonography