The 'CARFEM' vascular index as a predictor of coronary atherosclerosis.
BACKGROUND
The purpose of the study was detection of coronary atherosclerosis and identification of persons at risk by means of non-invasive examination of the carotid and peripheral arteries.


METHODS
Investigation of 366 patients: 229 males and 137 females divided into groups according to age and the severity of the coronary atherosclerotic lesions. Only patients with a coronary stenosis of more than 90%, who needed angioplasty or coronary bypass surgery, were included. Group I consisted of patients with normal coronary arteries; Group II, critical one-vessel disease; Group III, two-vessel disease; Group IV, critical three-vessel disease. By means of a vascular duplex scan we measured bilaterally the intima-media thickness of the posterior wall of the common carotid artery. In order to provide a more accurate estimation of the total atherosclerotic burden we have created the 'CARFEM' index (combination index of intima media thickness of carotid artery and total wall thickness of the superficial femoral artery).


RESULTS
The anthropometric data were identical among the different groups. There are statistically highly significantly differences in the intima-media thickness of the common carotid artery when patients with normal coronary arteries are compared with patients with three-vessel coronary disease. By calculating the 'CARFEM' index not only we can differentiate between patients with normal coronary arteries and patients with critical three-vessel disease, but there are also ways to differentiate between different subgroups and to assess possible one-vessel, two-vessel or three-vessel coronary artery disease.


CONCLUSIONS
The determination of the intima-media thickness of the common carotid artery clearly enables us to detect possible coronary atherosclerosis and to predict its severity in a non-invasive way. The combined assessment of the carotid and the femoral arterial walls permits us to make a distinction between the different subgroups, divided according to the severity of the underlying coronary atherosclerosis.
Claessens
Philip
P
Department of Cardiology, Hospital Sint Jan, Brugge, Belgium.
Claessens
Christophe
C
Claessens
Marc
M
Claessens
Maria
M
Claessens
Jan
J
D000328:Adult; D000368:Aged; D000465:Algorithms; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000473:pathology; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000473:pathology; D014463:Ultrasonography / Q000379:methods