Carotid artery intima-media thickness and plaque score can predict the SYNTAX score

Aims There are few reports demonstrating a relationship between carotid artery ultrasound (carotid-US) findings and the complexity of coronary artery disease. We aimed to examine the relationship between carotid-US findings and the severity of the SYNTAX score (SXscore). Methods and results Subjects were 501 consecutive patients who underwent carotid-US and first coronary angiography from December 2008 to January 2011. Carotid-US was used to determine the mean common carotid artery intima-media thickness (meanIMT) and the plaque score (PS). The prevalences of low (0-22), intermediate (23-32), and high (≥33) SXscore patients were 84.8, 7.4, and 7.8%, respectively. The SXscore was correlated with the meanIMT (Spearman's rank correlation coefficient; ρ = 0.442, P< 0.0001) and the PS (ρ = 0.544; P< 0.0001). The odds ratios associated with the meanIMT and the PS for prediction of an intermediate or the high SXscore were 1.24 and 1.31, respectively. The areas under the receiver-operating characteristic curves for the meanIMT and the PS to predict the intermediate or the high SXscore were 0.791 and 0.846, respectively. When we set the cut-off value of a meanIMT of 0.9 mm, the sensitivity was 92.1% for intermediate or the high SXscore. Similarly, a cut-off level of a PS of 5 presented a sensitivity of 96.1%. A meanIMT ≥0.9 mm and a PS ≥ 5 had negative predictive values of 97.3 and 98.6%, respectively, for intermediate or high SXscore. Conclusion Carotid-US parameters have predictive value for the SXscore. In addition, the PS and the meanIMT showed excellent negative predictive value for the presence of complex coronary artery lesions.