Evaluation of relationship between common carotid artery intima-media thickness and coronary in-stent restenosis: A case-control study.

Abstract

Aim: The study was intended to evaluate relationship of common carotid artery intima-media thickness (CIMT) with coronary in-stent restenosis (ISR) and to assess clinical profile of patients to determine the predictors of coronary ISR.

Methods: This was a single-center, case-control study performed between December 2012 and February 2015 in India. The study population consisted of PCI-treated patients with ISR (n = 32) and those without any post-PCI symptoms at least 6 months prior to the study period (n = 40). Quantitative coronary angiography was performed in patients to determine ISR.

Results: Average CIMT for cases and controls was 0.96 ± 0.23 and 0.66 ± 0.09 mm (OR = 57, p < 0.001), respectively. CIMT was <0.8 mm in 25% of cases and 95% of controls. On multivariate analysis, presence of hypertension (OR = 10.79, p = 0.026) and higher stent diameter (OR = 14.87, p = 0.039) were independently associated with increased presence of ISR. CIMT <0.8 mm (OR = 0.03, p = 0.025), STEMI (OR = 0.03, p = 0.004), and estimated glomerular filtration rate >50 ml/min (OR = 0.005, p = 0.014) were independently associated with lower presence of ISR.

Conclusions: Elevated CIMT appears to be an independent risk indicator for increased ISR. As CIMT is a non-invasive parameter, post-PCI follow-up measurements of CIMT in routine clinical practice will provide potential benefits to predict the restenosis rates.