title: Carotid intima-media thickness (CIMT) and carotid plaques in young Nepalese patients with angiographically documented coronary artery disease.
abstract: BACKGROUND
  Carotid intima-media thickness (CIMT) and carotid plaques are non-invasive surrogate markers of early evaluation of coronary artery disease (CAD) and sub clinical atherosclerosis. The objective of the study was to evaluate CIMT and carotid plaques in less than 45 years old Nepalese patients with angiographically proven CAD.
  
  
  METHODS
  A total of 54 patients with angiographically documented CAD at less than 45 years of age were enrolled. CAD was confirmed by coronary angiography. Demographic profile was obtained. High resolution B-mode ultrasound was used to detect the CIMT and carotid plaques.
  
  
  RESULTS
  The study population included 44 males and 10 females, with a mean ± SD age of 38.4±4.3 years (range, 25-44 years). Cardiovascular risks factors included smoking in 81%, Hypertension in 52%, diabetes in 19% and alcohol consumption in 78% of patients. Lipid profile (mean ± SD) was normal except for elevated triglyceride (TG) levels of 204±130.8 mg/dL. By angiography, 64.8% had single vessel disease, 26% had double vessel disease and 9.2% had triple vessel disease. Ultrasound detected either thickened CIMT or presence of plaques in 46 (85.2%) cases (group-A) and 8 (14.8%) had negative (normal) carotid study (group-B). Among the 46 patients with positive findings 63% had carotid plaques and 37% had thickened CIMT only. The majority (69%) of the carotid plaques were detected at the carotid bulbs. In total population, carotid plaque was detected in 53.7% of cases. There was no statistical significant difference of age, body mass index (BMI) and lipid level between group-A and group-B.
  
  
  CONCLUSIONS
  Increased CIMT and carotid plaques are detected in majority of the young Nepalese patients with angiographically documented CAD. The majority of carotid plaques are detected at the carotid bulbs. Routine carotid ultrasound study in young individuals with CAD risk factors appears worthwhile.
authors.affiliation: Department of Cardiology, Shahid Gangalal National Heart Centre, PO Box NO 11360, Karhmandu, Nepal.
authors.forename: Yuba Raj
authors.initials: YR
authors.lastname: Limbu
authors.affiliation: Department of Cardiology, Shahid Gangalal National Heart Centre, PO Box NO 11360, Karhmandu, Nepal.
authors.forename: Rajib
authors.initials: R
authors.lastname: Rajbhandari
authors.affiliation: Department of Cardiology, Shahid Gangalal National Heart Centre, PO Box NO 11360, Karhmandu, Nepal.
authors.forename: Ranjit
authors.initials: R
authors.lastname: Sharma
authors.affiliation: Department of Cardiology, Shahid Gangalal National Heart Centre, PO Box NO 11360, Karhmandu, Nepal.
authors.forename: Satish
authors.initials: S
authors.lastname: Singh
authors.affiliation: Department of Cardiology, Shahid Gangalal National Heart Centre, PO Box NO 11360, Karhmandu, Nepal.
authors.forename: Dipak
authors.initials: D
authors.lastname: Limbu
authors.affiliation: Department of Cardiology, Shahid Gangalal National Heart Centre, PO Box NO 11360, Karhmandu, Nepal.
authors.forename: Chandra Mani
authors.initials: CM
authors.lastname: Adhikari
authors.affiliation: Department of Cardiology, Shahid Gangalal National Heart Centre, PO Box NO 11360, Karhmandu, Nepal.
authors.forename: Dipankar
authors.initials: D
authors.lastname: Prajapati
keywords: Coronary artery disease (CAD); carotid intima-media thickness (CIMT); carotid plaques