Study On The Correlation Between Carotid Intima-media Thickness,Plaque,and Coronary Artery Disease In People Of Northern Henan

BackgroundCoronary heart disease(CHD)seriously endangers human health.Early diagnosis of CHD,timely and effective preventive measures are significant.The degree of coronary artery lesions can be reflected by the condition of peripheral atherosclerotic lesions.In clinical practice,the position of the carotid artery is superficial and constant,so it is often used to observe and evaluate atherosclerosis.Previous studies have shown that carotid IMT and carotid plaque formation can reflect the existence and pathological changes of CHD.However,the correlation between carotid intima-media thickness(IMT),plaque,and coronary artery disease in people of northern Henan is still not clear.ObjectiveTo study the correlation between carotid IMT,plaque,and coronary artery disease,and to analyze their predictive value for CHD.To analyze the correlation between carotid IMT,maximum plaque length,maximum plaque thickness,and coronary artery disease.To clarify the cut-off value and predictive value of carotid artery examination indexes in the diagnosis of CHD.MethodsFrom January 2016 to December 2018,a total of 1806 patients in northern Henan who underwent coronary angiography and carotid ultrasound examination were selected from the Engineering Research Center for Clinical Data and Biobank of Cardiovascular Disease in Heman Province.According to coronary angiography,they were divided into CHD group(n=1158)and non-CHD group(n=648).Furthermore,the population was divided into groups according to whether there was carotid artery IMT thickening and carotid artery plaque formation.Binary Logistic regression analysis was used to analyze the influencing factors.The propensity score match(PSM)method was used to eliminate the difference between the CHD group and the non-CHD group.The correlations between carotid IMT,plaque and the number of lesions,the degree of coronary artery disease and the type of CHD were analyzed.The differences of plaque properties between CHD group and non-CHD group and three types of CHD were analyzed.The correlation was analyzed by Spearman rank correlation method.The best diagnostic cut-off values were determined by receiver operating characteristic(ROC)curve.Results1.The proportion of patients with carotid IMT thickening,the proportion of patients with carotid plaque formation,the carotid IMT,maximum plaque length,and maximum plaque thickness of the CHD group were significantly greater than those of the non-CHD group(P<0.001).Binary Logistic regression analysis shows that,carotid IMT(OR=3.974,95%CI 1.094-14.440,P=0.036),maximum plaque length(OR=1.119,95%CI 1.085-1.153,P<0.001),and maximum plaque thickness(OR=1.745,95%CI 1.437-2.121,P<0.001)had statistically significant effects on the incidence of CHD.2.After PSM,the proportion of carotid plaque formation,maximum plaque length,and maximum plaque thickness of patients with CHD were higher than those of people without CHD(P<0.05).The proportion of patients with carotid IMT thickening and carotid plaque formation,maximum plaque length,and maximum plaque thickness in patients with three-vessel disease were greater than those in the normal people and those with single-vessel disease(P<0.05).The proportion of carotid IMT thickening and carotid plaque formation,maximum plaque length,and maximum plaque thickness in patients with severe lesions were higher than those in the normal group and patients with mild lesions(P<0.05).3.The soft plaques and mixed plaques in patients with CHD were more than those without CHD(35.9% vs.20.0%,P<0.05;19.1% vs.8.8%,P<0.05).Compared with hard plaques,the difference was not statistically significant(34.4% vs.26.1%,P<0.05).4.The results of Spearman rank correlation analysis showed that,compared with carotid IMT and maximum plaque thickness,maximum plaque length has a stronger correlation with the number of coronary artery lesions(r=0.269,P<0.001),Gensini score(r=0.260,P<0.001)and the degree of coronary artery disease(r=0.254,P<0.001).5.The sensitivity and specificity of carotid artery IMT thickening in the diagnosis of CHD were 62.2% and 46.1%,respectively.The sensitivity and specificity of carotid plaque formation in the diagnosis of CHD were 65.3% and 54.6%,respectively.6.The predictive value of maximum plaque length for CHD was higher than that of carotid IMT and maximum plaque thickness,the best cut-off value was 8.6mm.The area under the curve(AUC)is 0.624,with a sensitivity of 46.5% and and a specificity of 74.1%.The predictive value of maximum plaque length for severe coronary artery disease was higher than that of carotid IMT and maximum plaque thickness,and the best cut-off value was 9.0mm.The AUC was 0.651,with a sensitivity of 55.1% and a specificity of 66.1%.ConclusionsThe carotid IMT and carotid plaque in people of northern Henan can reflect the occurrence of CHD and the severity of coronary artery disease to a certain extent,and has a certain predictive value for CHD and severe coronary artery disease.Compared with carotid IMT and maximum plaque thickness,maximum plaque length showed a better value in predicting the existence and severity of CHD,and it may be more helpful to identify patients with CHD in early stage.