Journal-Femoral Artery Intima Media Thickness as a Predictor of Severity of Coronary Artery Disease

Femoral Artery Intima Media Thickness as a Predictor of Severity of Coronary Artery Disease

Yasser Gomaa, MD*, Ahmed A. Khashaba, MD*, Tarek Khairy, MD*, Aly A. Ramzy, MD**, Sameh Thabet, MD*, Adel Gamal, MD, Sameh Mossaad, MBBCH*, Tarek Zaky, MD*

* Cardiology Department, Ain Shams University, Cairo, Egypt. ** Cardiology Department, Al-Azhar University, Cairo, Egypt.

Background

Coronary angiography (CA) remains, so far, the gold standard for accurate diagnosis of the coronary artery disease (CAD), but it is not feasible as a screening test. Because atherosclerosis affects different vascular beds, as the aorta, carotids, and femoral arteries, many non-invasive tests were developed aiming at assessment of the intima-media complex of different arterial walls. Few studies approved correlation between common femoral artery (CFA) intima-media thickness (IMT) and the severity of the atherosclerotic CAD.

Methods

The study was conducted in Ain-Shams University Hospital, and included 100 patients who were scheduled for CA for different indications. Proper history taking, clinical examination, lab assessment of serum lipids and fasting blood sugar were done. Femoral artery B-mode ultrasound was used to measure the CFA- IMT of the posterior wall.

Results

The study showed a significant correlation between the CFA-IMT and the severity of the atherosclerotic CAD expressed as the number of vessels with ≥ 50% stenosis. It also showed significant correlation between the CFA-IMT and most of the studied cardiovascular risk factors. We also found that the best cutoff value of the CFA-IMT to distinguish patients with atherosclerotic CAD from those with normal coronaries was 0.64 mm, with sensitivity of 91% and specificity of 88%.

Conclusion

CF-IMT is clearly affected by the different cardiovascular risk factors. Therefore, it could be used as a scale for assessment of the atherosclerotic burden. CFA-IMT could be considered to certain degree, a mirror of the coronary arteries, which can reflect the severity of the atherosclerotic CAD and could be used as a non-invasive screening tool (at a cut off value of 0.64 mm) for assessment of the severity of the underlying CAD.

Keywords

Femoral intima media thickness, Coronary artery disease, Risk factors.