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From Affiliated Egyptian Universities and Cardiology Centers

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Background:Carotid artery intima-media thickness (CIMT), a subclinical measure of atherosclerosis, is associated with coronary artery disease (CAD), and stroke. CIMT is also an important predictor of clinical cardiovascular events. Yet the relation between CIMT and the spread of atherosclerosis is not well investigated. On the other hand C-reactive protein (CRP) is considered as a marker for atherosclerosis, but there are no enough studies to investigate its direct relation to increased CIMT. AIM: To Evaluate the CIMT as a predictor of atherosclerotic spread by studying the relation between the increased CIMT and the number of arterial territories affected by significant stenotic lesions and to investigate the relation between high sensitivity CRP (hs-CRP) level and increased CIMT. Methods: The study included 40 patients (33 males), aged 50.5±6.8 years, referred to coronary angiography for various reasons. CIMT was measured bilaterally in common, internal carotid arteries and bifurcation and expressed as the mean aggregate value. In all patients coronary and renal arteries were assessed through angiography and femoral and carotid artery stenoses were assessed through B-mode ultrasound. CRP was measured on high sensitivity basis. Results :According to the number of arterial territories involved with significant lesions, patients were subdivided into four groups; group A (10 patients) had no lesions in any arterial territory, group B (14 patients) had lesions in one territory, group C (10 patients) had lesions in two territories, and group D (6 patients) had lesions in three territories. CIMT strongly increased in relation to hypertension, diabetes mellitus, dyslipidemia, blood sugar level and increased level of high sensitivity CRP. Both CIMT and Hs-CRP were strongly correlated to the presence, extent of coronary artery disease, carotid and femoral stenosis and to the presence of multi territorial affection. Conclusions: Increase in CIMT is associated with the increase in number of arterial territories affected by significant atherosclerotic lesions. CIMT is an independent predictor of multi-level atherosclerosis, with high sensitivity and specificity. CIMT is strongly correlated to the increased level of CRP. Keywords: CIMT,CRP,Atherosclerosis.