Role of femoral intima-media thickness in risk prediction and assessment of severity of coronary artery disease.

Background/objective: Atherosclerosis is a systemic multifocal disease which most commonly involves branching points of the large and medium-sized arteries. The carotid intima-media thickness (c-IMT) is an established marker for increased cardiovascular risk and cerebrovascular disease. In this study, we aimed to establish the role of femoral intima-media thickness (FIMT) in predicting cardiovascular risk in angiographically confirmed patients of coronary artery disease (CAD) when compared with apparently healthy patients (having normal coronary angiogram).

Methods: A total of 114 consecutive patients presented at our institute with symptoms of CAD who underwent coronary angiogram were included in the study. After the coronary angiogram, patients were divided into three groups, group A having normal coronary angiogram, group B having CAD with a synergy between percutaneous coronary intervention with taxus and cardiac surgery (SYNTAX) score of more than 22, and group C having CAD with a SYNTAX score of 22 or less. The Doppler ultrasound of the bilateral femoral artery in each patient was done 1 day before a coronary angiogram and FIMT was recorded.

Results: There was a significant difference (-value -  < 0.001) found in the mean FIMT in patients with normal coronaries (mean FIMT - 0.49 ± 0.05) and patients having CAD (mean FIMT - 0.73 ± 0.17). The area under the receiver operating characteristic (ROC) curve of mean FIMT in predicting abnormal coronaries was 0.903 (95%CI 0.847-0.958,  < 0.001).

Conclusion: The FIMT has a strong correlation with coronary artery disease. With the help of this non-invasive tool, we can diagnose subclinical atherosclerosis and it may contribute to the prevention of CAD and its severe manifestations.