Intima-media thickness of the common femoral arteries as a marker for coronary atherosclerosis in patients with coronary artery disease

Aim

To study the relationship of intima-media thickness (IMT) of the common and superficial femoral arteries with the severity of coronary atherosclerosis in patients with coronary artery disease (CAD), and to evaluate the diagnostic value of femoral IMT for the coronary artery stenosis ≥50%.

Material and methods

We recruited 80 patients aged 40 to 70 years with stable CAD. All patients underwent a duplex scan of the carotid and lower limb arteries. The IMT was measured manually in a place free of atherosclerotic plaque on both sides in common carotid arteries, common femoral arteries (CFA), and superficial femoral arteries (SFA). Invasive polypositional coronary angiography was performed on an Innova 3100 angiographic system.

Results

More than half of patients had a history of myocardial infarction, and 47.5% of patients underwent coronary revascularization. Carotid atherosclerosis and femoral atherosclerosis were detected in 90.0% and 87.5% of patients, respectively. Coronary artery stenosis ≥50% was found in 77.5% of patients, whereas carorid and femoral arteries stenosis ≥50% occurred significantly less frequently. IMT CFA (r=0.343; p=0.008) and IMT SFA (r=0.477; p<0.0001) directly correlated with the SYNTAX score. According to the ROC analysis, an increase in IMT CFA ≥0.83 mm predicted coronary artery stenosis ≥50% with a sensitivity of 72.1% and a specificity of 61.1%.

Conclusion

. In patients with stable CAD, IMT of the femoral but not carotid arteries directly correlated with the severity of coronary atherosclerosis, assessed by the SYNTAX scale, and predicted coronary artery stenosis ≥50%.

Key words

Intima-media thickness, femoral atherosclerosis, coronary artery disease, SYNTAX score.