| Objects: To evaluated gender differences and the clinical value of carotid intima-media thickness (IMT) in predicting coronary artery disease (CAD).Methods: 278 patients who have suspected coronary artery disease for various reasons had undergone standard Judkins selected coronary angiography, and they also accepted carotid artery ultrasound .Maximal IMT and plaques were assessed bilaterally at the common carotid, and expressed as mean IMT for each patient. According to gender and the results of coronary angiography, all patients were divided into four groups: 71 women (60.4±8.7 years of age) had angiographically confirmed CAD, 19 women (56.8±9.1 years of age) did not have CAD, 109 men (58.2±8.3 years of age) had CAD and 79 men (55.1±7.6 years of age) did not have CAD. Cardiovascular risk factors (hypertension, smoking, and diabetes, et.) were obtained from each patient.Results: Among patients who did not have CAD, women had lower mean IMT values than men (0.82±0.12 vs. 0.96±0.08, p < 0.05). This gender difference was not seen in patients who had CAD (1.06±0.13 vs. 1.08±0.17, p>0.05). Among women and men, those with CAD had larger IMT values than those without CAD. Multivariable regression analysis showed that age, CAD, hypertension, smoking, and diabetes had the strongest effect on IMT values in women and men. Receiver-operator characteristic(ROC)analysis showed that women had a significantly lower IMT threshold for likelihood of CAD (p < 0.001) and that a mean IMT of 0.963mm was highly predictive of concomitant CAD (sensitivity 84.5%, specificity 89.5%, positive predictive value 96.8%); for men, the mean IMT threshold was 1.020mm (sensitivity 63.3%, specificity 70.9%, positive predictive value 75.0%). In conclusion, carotid IMT assessment may be a valuable tool in selecting patients for coronary angiography to predict the likelihood of CAD.
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