Endocrine Abstracts

Carotid intima–media thickness (IMT) has been shown an independent predictive marker of coronary artery disease (CAD) and cardiovascular disease in many studies. We investigated the usefulness of carotid IMT as a screening test for CAD in Korean diabetic patients. We conducted retrospective study and found the type 2 diabetic patients without cardiovascular disease history who underwent carotid ultrasonography (US) and stress echocardiography (SE) from June 2006 to December 2012 at Kyung Hee University Hospital at Gangdong. Total 218 patients were reviewed by medical record, laboratory data, carotid US, SE, and coronary angiography results. Carotid US abnormalities were defined as ≥1 mm IMT or detection of plaque. Significant CAD was defined as ≥50% luminal narrowing in ≥1 epicardial arteries or their major branches. We assessed predictive value for CAD according to results of carotid US or SE.

116 patients (53.2% of 218 patients) had carotid US abnormalities and 34 patients (15.6% of 218 patients) shown positive SE. Patients with carotid plaque were old age (65.4±9.5 years vs 56.7±9.3 years, P<0.001), had long duration of diabetes (11.8 years vs 7.8 years, P<0.001), and low BMI (25.1±3.4 kg/m² vs 26.4±3.6 kg/m², P<0.001) compared to patients with normal carotid US. However, there was no difference in prevalence of positive SE between patients with carotid plaque and patients with normal carotid US (15.5% vs 15.7%, P=0.968). In patients with positive SE, there was no difference in prevalence of significant CAD whether they had carotid plaque or not.

52 of 218 patients underwent coronary angiography. 32 of 52 patients had positive SE and positive predictive value of SE in significant CAD was 84.4% (27 of 32 patients). Of 32 patients with positive SE, 16 patients had carotid plaque and all of them had significant CAD. In conclusion, carotid US abnormalities alone had limitation to correlated SE results and predict significant CAD. However, when taking into carotid US results with SE results, they improved positive predictive value in significant CAD.