Atherosclerotic coronary artery disease: The accuracy of measures to diagnose preclinical atherosclerosis

Different methods can be used to diagnose early pre-clinical stage atherosclerosis. The present study was carried out to evaluate the efficiency of these methods. Measures including carotid intima-media thickness (CIMT), pulse wave velocity (PWV), and coronary calcium score (CCS) were evalutated for the detection of coronary artery disease (CAD). We studied the clinical and biochemical profiles of individuals with non-CAD and CAD to assess measures of pre-clinical atherosclerosis. The association between CIMT, PWV and CCS on the one hand, and the coronary atherosclerosis on the other, was studied. In total, 150 cases of cardiovascular disease (CVD) participated in the present study and were subjected to computed tomographic (CT) coronary angiography to divide them into non-CAD (n=100) and CAD (n=50) groups. The patients were also subjected to pre-clinical atherosclerosis tests (CIMT, PWV and CCS). CAD patients had higher CIMT values on both sides (right side, 0.74±0.09 vs. 0.62±0.12 mm; left side, 0.78±0.16 vs. 0.64±0.19 mm; and average, 0.76±0.12 vs. 0.63±0.14 mm; all P-values <0.01). These patients also had significantly higher brachial-ankle PWV (baPWV) on left side (1638.8±372.9 vs. 1498.6±339.8 cm/sec, P<0.001). The overall CCS was significantly increased in CAD patients as compared to the patients without CAD (117.8±118.6 vs. 8.6±18.3, P<0.001). In conclusion, the present study showed that among different measures of preclinical atherosclerosis, CCS had the best diagnostic accuracy. However, the combination of CIMT and baPWV had an excellent negative predictive value for atherosclerotic coronary vascular disease.