title: The predictive value of flow-mediated dilation and carotid artery intima-media thickness for occult coronary artery disease.
abstract: BACKGROUND
  Multidetector row computed tomography (MDCT) is an attractive noninvasive alternative to assess overall coronary artery disease (CAD) burden and may reveal coronary plaques, which may be underestimated by conventional coronary angiography. The aim of this study was to determine whether brachial artery flow-mediated dilation (FMD) and carotid artery intima-media thickness (CIMT) might accurately predict patients with occult coronary plaques whose conventional coronary angiographies revealed normal coronary arteries (NCA).
  
  
  METHODS
  Thirty-five patients with angiographically NCA were consecutively recruited into the study. They underwent MDCT and were divided into NCA group (18 patients; 8 male; 47 ± 9 years) and occult CAD group (17 patients; 11 male; 50 ± 10 years) according to presence of coronary plaque. Nineteen consecutive patients with evident CAD (16 male; 54 ± 7 years) and 19 healthy subjects (10 male; 50 ± 6 years) were included as control groups. FMD and CIMT were measured by brachial and carotid artery ultrasonography.
  
  
  RESULTS
  Occult CAD group had significantly lower FMD and insignificantly higher CIMT than NCA group whereas they had significantly higher FMD and insignificantly lower CIMT than evident CAD group. NCA group had significantly lower CIMT than evident CAD group. Receiver operating characteristic curve analysis demonstrated FMD < 8% (sensitivity: 94.4%; specificity: 73.0%; PPV: 77.3%; NPV: 93.1%) and CIMT ≥ 0.65 cm (sensitivity: 72.2%; specificity: 62.2%; PPV: 65.0%; NPV: 69.7%) could predict patients with CAD. FMD and CIMT were independent predictors of CAD (P < 0.001; OR: 45.630; 95%CI: 5.38-386.983 and P = 0.015; OR: 14.226; 95%CI: 1.666-121.467, respectively).
  
  
  CONCLUSIONS
  FMD and CIMT might predict patients with occult CAD and be helpful in selecting patients for MDCT.
authors.affiliation: Department of Cardiology, Marmara University Faculty of Medicine, Istanbul, Turkey.
authors.forename: Bulent
authors.initials: B
authors.lastname: Mutlu
authors.forename: Kursat
authors.initials: K
authors.lastname: Tigen
authors.forename: Emre
authors.initials: E
authors.lastname: Gurel
authors.forename: Beste
authors.initials: B
authors.lastname: Ozben
authors.forename: Tansu
authors.initials: T
authors.lastname: Karaahmet
authors.forename: Yelda
authors.initials: Y
authors.lastname: Basaran
mesh_terms: D000465:Algorithms; D002339:Carotid Arteries / Q000000981:diagnostic imaging*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D003326:Coronary Circulation; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D017539:Tunica Intima / Q000000981:diagnostic imaging*; D014463:Ultrasonography; D014664:Vasodilation; D014665:Vasodilator Agents
chemical_list: D014665:Vasodilator Agents