Role of Carotid Intima-Media Thickness in Predicting Coronary Artery Disease Severity

Background: Coronary angiography is considered the gold standard for diagnosing coronary artery disease (CAD). However, carotid Doppler ultrasonography offers a highly effective, non-invasive alternative for identifying atherosclerosis. Carotid intima-media thickness (CIMT) has emerged as an independent predictor of obstructive CAD. Objective: To determine the severity of coronary artery disease based on carotid intima-media thickness in patients presenting to the Armed Forces Institute of Cardiology, Rawalpindi. Methodology: A total of 284 patients of both genders who underwent coronary angiography for the evaluation of CAD were enrolled and divided into two groups of 142 each. Group A included patients with obstructive CAD (≥50% stenosis in at least one coronary vessel), while Group B included those without obstructive CAD. CIMT measurements were obtained bilaterally, and the mean of the left and right values was recorded. Statistical analysis was conducted using SPSS version 25, with a p-value <0.05 considered statistically significant. Results: The mean age of participants was 59.35 ± 11.55 years. Of the 284 patients, 181 (63.7%) were male and 103 (36.3%) were female. The mean CIMT in Group A (obstructive CAD) was 1.03 ± 0.22 mm, significantly higher than in Group B (non-obstructive CAD), which was 0.88 ± 0.15 mm (p < 0.001). Conclusion: Carotid intima-media thickness is a reliable and non-invasive marker that can effectively predict the severity of coronary artery disease. Its incorporation into routine cardiovascular risk assessment may enhance early detection and intervention. Keywords: Carotid Intima-Media Thickness, Carotid, Atherosclerosis, Coronary Artery Disease, Doppler, Ultrasonography.