颈动脉粥样硬化与冠状动脉狭窄程度的关系

探讨颈动脉粥样硬化病变的性质、程度及其与冠状动脉狭窄程度的关系。选择200例冠状动脉造影患者，并经颈动脉DSA及B超检查。根据造影结果分为冠心病组和非冠心病组(对照组)。根据冠状动脉狭窄直径，冠心病组再分成三个亚组。结果发现，颈动脉粥样硬化与冠状动脉狭窄之间呈线性正相关，颈动脉狭窄较冠状动脉狭窄发生率低，但随着冠状动脉狭窄程度加重，颈动脉粥样斑块的发生率明显增加，且颈动脉狭窄亦有加重趋势。结果提示，颈动脉粥样硬化与冠状动脉狭窄密切相关。对中年以上人群，尤其是有多种危险因素者，常规进行颈动脉超声检查，可为早期发现和筛选心脑血管疾病高危患者提供依据。     

Newly diagnosed carotid atherosclerosis in patients with coronary artery disease admitted for cardiac rehabilitation.

BACKGROUND: The association of coronary artery disease (CAD) with carotid artery disease has been well documented. However, data focusing on CAD patients participating in cardiac rehabilitation programs are lacking. We studied the prevalence of newly diagnosed carotid artery disease in CAD patients admitted for cardiac rehabilitation. METHODS: We performed carotid ultrasonography in 168 angiographically confirmed CAD patients admitted to two facilities. Patients with previous cerebrovascular episodes or carotid imaging were excluded. RESULTS: Out of 168 patients considered (mean age 65 +/- 8 years; males 76%; chronic stable angina as the reason for cardiac rehabilitation 34%, silent ischemia 14%, and acute coronary syndrome 52%), 149 (89%) were found to have carotid atherosclerosis. Carotid atherosclerosis was present in 83, 87, 89, and 93% of patients with one-, two- and three-vessel disease and left main stem CAD respectively. Patients with severe CAD (i.e. three-vessel or left main stem) had a higher prevalence of > or = 50% carotid stenosis as compared to patients without severe CAD (26 vs 8%, p < 0.05). Severe CAD had a high negative (92%) and a low positive (26%) predictive value for the presence of > or = 50% carotid stenosis. CONCLUSIONS: Silent and previously undetected carotid atherosclerosis is frequent in CAD patients admitted for cardiac rehabilitation. The absence of severe CAD reflects the absence of > or = 50% carotid stenosis.     

The role of carotid atherosclerosis in the distinction between ischaemic and non-ischaemic cardiomyopathy.

AIM: Sometimes ischaemic cardiomyopathy is a result of severe coronary artery disease of an occult course, without typical symptoms or evidence of myocardial infarction. This form of presentation is usually indistinguishable from non-ischaemic dilated cardiomyopathy. Carotid bifurcation atherosclerosis and coronary artery disease have been shown to be strongly associated. We prospectively examined the value of extracranial carotid atherosclerosis in the distinction between ischaemic and non-ischaemic aetiology in patients with clinically unexplained cardiomyopathy. METHODS AND RESULTS: Seventy-eight patients with undetermined dilatation and diffuse impairment of the left ventricular contraction were studied within 28 months. They underwent carotid scan and coronary arteriography. Carotid atherosclerosis was found to be very common in ischaemic and rare in non-ischaemic cardiomyopathy. The presence of at least one abnormal carotid finding (intima-media thickness >1 mm, plaques, severe carotid stenosis) was 96% sensitive and 89% specific for ischaemic cardiomyopathy. CONCLUSION: Carotid scanning may be a useful screening and decision making tool in patients with cardiomyopathy of indecisive cause. Patients with carotid atherosclerosis are likely to suffer from severe coronary artery disease. Coronary angiography and subsequent myocardial viability studies, when indicated, could be considered early during their evaluation. In contrast, a negative carotid scan predicts non-ischaemic cardiomyopathy.     

颈动脉粥样硬化与冠状动脉旁路移植术后神经系统并发症相关性研究

目的:探讨颈动脉粥样硬化程度与非体外循环下冠状动脉旁路移植术后,神经系统并发症的关系。方法:连续选择择期行非体外循环下冠状动脉旁路移植术的患者475例,根据颈动脉超声结果分为四组:无狭窄、轻度、中度及重度狭窄,分析狭窄程度与术后神经系统并发症的关系及影响因素。结果:①四组患者之间年龄、脑卒中病史、糖尿病史及神经系统并发症比较,差异有统计学意义(P<0.05);②颈动脉狭窄患者术后神经系统并发症的发生率高于无颈动脉狭窄患者(χ2=3.851,P=0.050);③脑卒中病史(OR=1.835,95%CI:1.023～3.289,P<0.05)、颈动脉重度狭窄(OR=2.793,95%CI:1.296～6.018,P<0.05)与术后神经系统并发症相关(P<0.05)。结论:脑卒中病史、颈动脉重度狭窄是旁路移植术后神经系统并发症的危险因素。颈动脉不论狭窄程度,均可导致术后神经系统并发症发生率增高,低灌注可能为主要原因。     

Carotid artery involvement in patients of atherosclerotic coronary artery disease undergoing coronary artery bypass grafting

BACKGROUND: Patients with concomitant critical carotid and coronary artery disease are at risk of major neurological events while undergoing coronary artery bypass grafting. The presence of carotid artery stenosis increases the stroke rate in the perioperative period. In an effort to reduce the stroke rate, many institutions perform routine preoperative noninvasive assessment of the carotid arteries. METHODS AND RESULTS: We analyzed the clinical and laboratory data of 1,200 patients who underwent coronary artery bypass surgery in the last 2 years. Carotid Doppler was normal in 186 patients (15.5%), and showed <30% stenosis in 796 (66.3%), 30%-50% in 110 (9.2%), 50%-70% stenosis in 64 (5.3%) and critical (>70%) stenosis in 44 (3.7%) patients. Conventional risk factors such as hypercholesterolemia, hypertension, smoking and family history were not independent predictors of carotid artery stenosis. However, diabetes as a risk factor had a significant association with carotid artery disease (79.6% v. 43.8%, p<0.02). There was a trend towards increased prevalence of carotid artery stenosis in patients with > or = 2 risk factors (84.3% v. 68.8%). Patients with significant carotid artery stenosis had severe coronary artery disease (triple-vessel disease 93.3%, left main coronary artery disease 12.0%). Out of 44 patients with critical carotid artery stenosis, 27 were subjected to carotid angiography. Doppler findings correlated well with angiography. Seventeen patients underwent carotid artery intervention. None had any perioperative neurological events. A total of 5 (0.4%) patients had a major stroke. Coronary artery bypass grafting was done in 27 patients with critical stenosis without any intervention. The stroke rate (11.1%) was higher in these patients compared to patients with < 70% carotid artery disease or post-carotid intervention (2.5%) patients. Thus, untreated >70% carotid artery stenosis was associated with a higher stroke rate. CONCLUSIONS: Doppler screening of the carotid artery is helpful in detecting the subgroup of patients at increased risk of stroke. Patients with critical carotid artery stenosis should be subjected to angiography. Prophylactic intervention may reduce the occurrence of stroke in the perioperative period.     

应用血管内超声显像技术评价冠状动脉病变与颈动脉病变相关性

目的 通过研究血管内超声、冠状动脉造影检查结果与体表颈动脉超声检测的颈动脉病变的相关性,分析颈动脉粥样硬化与冠心病的关系,进一步探讨颈动脉粥样硬化对冠心病发病的预测价值.方法 38例拟诊为冠心病的患者行冠状动脉造影、血管内超声和体表颈动脉超声检查,其中8例患者经冠状动脉造影和血管内超声检查未发现冠状动脉有明显狭窄病变为对照组;30例经冠状动脉造影和血管内超声检查发现冠状动脉有明显狭窄病变为冠心病组,其中不稳定型心绞痛18例,稳定型心绞痛12例.将血管内超声及冠状动脉造影检查结果与颈动脉超声指标进行分析比较.结果 30例冠心痛患者冠状动脉造影平均直径狭窄率71.21%±9.81%,血管内超声示有不同类型的动脉粥样硬化斑块,平均面积狭窄率80.88%±7.77%;8例对照组无动脉粥样硬化斑块.冠状动脉造影平均直径狭窄率与血管内超声平均面积狭窄率之间差异有显著性(P<0.01);冠状动脉造影平均直径狭窄率与血管内超声平均面积狭窄率之间有显著相关性(r=0.663,P<0.01).根据冠状动脉造影平均直径狭窄率计算的Gensini积分分别与颈动脉粥样硬化的等级积分、Crouse积分和斑块数三项指标间均有相关性(P<0.01).颈动脉斑块对冠心痛的阳性预测值为70%(21/30),阴性预测值为75%(6/8).结论 应用血管内超声显像技术能准确诊断冠状动脉斑块的性质并测量冠状动脉狭窄率;与冠状动脉造影相比,血管内超声对评价冠状动脉病变更准确.颈动脉粥样硬化严重程度与冠状动脉血管内超声检查结果有很好的相关性;颈动脉超声检测对冠心病的诊断有一定的预测价值.     

Disease of the left main coronary artery: early surgical results and their association with carotid artery stenosis.

OBJECTIVES--To review the results of surgical revascularisation for left main coronary artery stenosis and the associated vascular pathology that is responsible for cerebrovascular complication. PATIENTS--60 patients (45 men, 15 women) (mean age 61.3 (39-79)) who underwent revascularisation for stenosis of the left main stem coronary artery (LMS) between January 1987 and August 1990 were compared with an age and sex matched control group of patients undergoing revascularisation for triple vessel disease during the same period. OUTCOME MEASURES--In-hospital morbidity and operative mortality. RESULTS--24 patients in the LMS group presented with unstable angina. The left ventricular ejection fraction was less than 50% in 30 patients and less than 30% in nine. 17 patients (28%) had large vessel extracranial carotid artery disease and 10 patients had vascular disease of the lower limbs. In six patients atheromatous plaques were noted in the ascending aorta during surgery. There was no in-hospital mortality. In-hospital morbidity included neurological deficits in five (8.3%), arrhythmias in seven (11.6%), and pulmonary complications in six (10%) patients. The incidence of carotid artery disease in the LMS group was significantly higher (p = 0.04). Atheromatous plaque in the ascending aorta and postoperative neurological complications were more common patients with LMS. CONCLUSIONS--The incidence of carotid artery disease was higher and postoperative cerebrovascular complications were more common in patients who had coronary artery revascularisation for stenosis of the left main stem coronary artery. The early surgical results were excellent. These findings suggest that for optimum perioperative management patients with stenosis of the left main coronary artery should be screened for carotid artery disease before bypass surgery.     

Risk factors in the combination of myocardial infarction and carotid atheroma

This study compares two groups of patients: Group I with 44 patients who suffered recent acute myocardial infarction and Group II: 40 control subjects. In both groups, 2D Doppler echocardiography was performed to detect carotid atheroma, to determine the respective roles of vascular risk factors for two sites of atherosclerosis. Carotid atheroma affected 73 p. 100 of subjects in Group I and 22.5 p. 100 in Group II. Carotid stenosis of more than 40 p. 100 was found mainly in hypertensive patients who presented with acute myocardial infarction, and in patients with left ventricular hypertrophy. Smoking was more frequent in Group I than in Group II (p less than 0.001) irrespective of the frequency of carotid atheroma (p less than 0.05). Hypercholesterolaemia only favoured carotid atherosclerosis after acute myocardial infarction (p = 0.01). We did not find any difference in the incidence of diabetes mellitus in the two groups of patients. Age analysis indicated that carotid atheroma occurred earlier in Group I than in Group II. An association between a dominant risk factor for coronary disease (smoking or hypercholesterolemia) was found in 9 patients, all of whom had severe bipolar atherosclerosis with multivessel coronary lesions and carotid stenosis.     

颈动脉粥样硬化对冠状动脉病变的预测分析

目的探讨颈动脉粥样硬化对冠状动脉病变的预测价值.方法对191例确诊为冠心病的患者及175例正常对照者行颈动脉超声检查,依冠状动脉造影结果分为对照组与冠心病单支病变组、双支病变组及多支病变组,比较各组间颈动脉内膜-中膜厚度及粥样硬化程度;并根据颈动脉粥样硬化的程度预测冠心病的发生、发展情况.结果对照组与冠心病各组在左侧内膜-中膜厚度、斑块发生率和狭窄率上存在差并(P＜0.05),而且冠状动脉病变支数越多颈动脉粥样硬化的程度也越重.以颈动脉斑块分级计分大于1、2和3分为标准预测冠心病的阳性预测值分别是68.5%、73.2%和74.6%.结论以上提示颈动脉粥样硬化是冠状动脉粥样硬化有价值的预测因素,通过颈动脉粥样硬化程度可预测冠状动脉病变的存在及其严重程度.     

Exaggerated carotid sinus massage responses are related to severe coronary artery disease in patients being evaluated for chest pain

Background: Previous studies have reported that carotid sinus massage responses are associated with advancing age and carotid or coronary artery disease. Hypothesis: This study was undertaken to investigate the potential role of carotid sinus hypersensitivity as a marker for the presence of coronary artery disease, and especially left main stem disease, in patients who were referred for evaluation of chest pain. Methods: Toward this end, carotid sinus stimulation with simultaneous recordings of the electrocardiogram and aortic pressure was performed before coronary arteriography in 150 selected consecutive patients (mean age 59.4 ± 9 years) who were referred for evaluation of chest pain. Results: Coronary artery disease was present in 118 patients (78.7%); of these, 35 had single‐vessel disease, 35 had double‐vessel disease, 33 had triple‐vessel disease, and 15 had left main stem with or without such vessel disease. Carotid sinus hypersensitivity was found in 40 patients (26.6%). The incidence of hypersensitivity in patients with single‐, double‐, or triple‐vessel disease and left main stem disease was 8.5, 14.2, 57.5, and 73.3%, respectively. Stepwise multiple logistic regression analysis revealed that left main stem disease was significantly and independently related to the presence of carotid sinus hypersensitivity (p < 0.05). In addition, the presence of hypersensitivity had 73.3% sensitivity, 86.2% specificity, and 96.3% negative predictive value for the presence of left main stem disease. Conclusion: In patients being evaluated for suspected ischemic heart disease, carotid sinus massage responses are related to severe coronary disease. The absence of hypersensitivity may reflect absence of left main stem disease.     

颈动脉粥样硬化与冠状动脉粥样硬化的关系

目的　探讨颈动脉粥样硬化与冠状动脉粥样硬化的关系。方法　对 94例老年患者进行了冠状动脉造影和颈动脉超声检查。颈动脉粥样硬化斑块积分采用Sutton法。结果　单支组及多支组内膜中膜厚度、斑块积分显著高于正常组 ,多支组显著高于单支组 (P<0 .0 5 )。斑块指数与年龄、吸烟、低密度脂蛋白胆固醇与高密度脂蛋白胆固醇的比值、收缩压以及高血压病程的程度呈正相关。结论　颈动脉粥样硬化与冠状动脉粥样硬化的病变是平行的     

Carotid intima-media thickness as an independent predictor of coronary artery disease.

BACKGROUND: A noninvasive technique of measuring carotid artery intima-media thickness has recently generated considerable interest as a marker of atherosclerosis and in the prediction of clinical coronary events and coronary artery disease. The present study evaluated the association of carotid artery intima-media thickness in the prediction of coronary artery disease in a western Indian population. METHODS AND RESULTS: Carotid artery intima-media thickness was measured with a B-mode scan in an ongoing study of 266 patients, who were further subdivided into 4 subgroups: those with non-insulin dependent diabetes mellitus; hypertension; diabetes mellitus with hypertension; and those without diabetes or hypertension (labeled as controls). The maximal intima-media thickness greater than 0.8 mm at the far wall of the common carotid artery, excluding raised lesions and plaques, was selected as the highest value for comparison. The subgroups were further divided into those with and without apparent coronary artery disease. A statistically significant intima-media thickness greater than 0.8 mm was observed in 59.2% of the subjects with coronary artery disease as against 40.8% in those without the disease on univariate analysis. A higher incidence of intima-media thickness of more than 0.8 mm was observed in all subgroups with coronary artery disease as against those without the disease, which was most marked in the hypertensive group (22.2% v. 3.6%) and contributed to the increased arterial thickness in diabetics with concomitant hypertension. Multivariate regression analysis revealed carotid artery intima-media thickness to be associated with coronary artery disease with an odds ratio of 2.40. CONCLUSIONS: Carotid artery intima-media thickness is a simple, noninvasive and reproducible clinical tool to evaluate atherosclerosis and predict coronary artery disease in Indian subjects. Prospective studies in a larger number of subjects, particularly in those undergoing coronary angiography, will help in establishing the role of this technique.     

Quantification of carotid atheroma, by vascular ultrasonics and spectral analysis, after myocardial infarction. Apropos of 80 cases

A prospective study of carotid artery atheroma by vascular echotomography and spectral analysis was performed in 40 patients with myocardial infarction and 40 control subjects. Carotid artery atheroma was commoner in the group of patients with myocardial infarction (72.5% +/- 6.8%), earlier (9 years), more commonly bilateral (37.5% +/- 7.6%) and more stenotic (32.5% +/- 7.4%) than in the control group (p less than 0.000a, p less than 0.0001 and p less than 0.002, respectively). The severity of carotid artery atheroma correlated with the site of coronary artery disease; the following significant relationships were found: stenosing 40% and/or bilateral carotid atherosclerosis and left anterior descending disease (p less than 0.02); carotid atherosclerosis and double or triple vessel disease (p less than 0.05). The authors conclude that detection of carotid artery atheroma after myocardial infarction is valuable for two reasons: it gives an indication as to the severity of the coronary disease; carotid endarterectomy may be considered at the same time as coronary artery bypass surgery.     

颈动脉粥样硬化与冠心病关系的研究

目的:研究颈动脉粥样硬化与冠心病的关系。方法:对301例冠状动脉造影的患者作双侧颈动脉超声检查,根据冠脉造影结果分为正常组及冠心病组,冠心病组根据冠状动脉病变支数再分为一支病变组,二支病变组,三支病变组3个亚组。测量颈总动脉后壁内中膜厚度(IMT),斑块厚度,计算斑块积分及粥样斑块发生率。结果:(1)冠心病组IMT,斑块积分及斑块发生率明显高于正常对照组(P<0.01)。(2)随冠脉病变支数增加,斑块积分及IMT增加,亚组比较有显著性差异(P<0.01)。(3)以IMT>0.85mm和(或)出现粥样斑块预测冠心病,特异性75.3％,敏感性84.6％,阳性预测率88.4％。结论:通过颈动脉超声检查可为冠心病的诊断提供依据。     

Classification and Atherosclerosis Distribution in Patients with Left Main Coronary Disease

Objective: The purpose of this investigation was to characterize clinical variables and angiographic distribution of coronary atherosclerosis to classify patients with de novo left main (LM) disease in a real-world population presenting for coronary angiography.
Background: Limited quantitative and angiographic published data exist that provide detailed quantitative information to classify potential target population for elective LM percutaneous coronary intervention (PCI) and guide development of dedicated LM PCI platforms.
Methods: Medical history and clinical presentation were prospectively collected on 177 consecutive patients with LM stenosis ≥50% by coronary angiography. Blinded quantitative coronary angiography (QCA) was performed on all LM stenoses to classify LM-A (ostial), LM-B (nonostial, non-bifurcation), and LM-C (bifurcation involvement). QCA was performed on the left anterior descending (LAD), left circumflex (LCx), and right coronary arteries (RCA) and branches (≥2.5 mm) to identify lesions with ≥60% stenosis or occlusion.
Results: No differences in baseline clinical history or presentation discriminated the distribution patterns of LM stenosis. QCA revealed 66% of LM stenoses were LM-C. Mean LM reference vessel diameter was 4.65 mm and average lesion length was 11.12 mm. Around 88.7% of patients had at least one lesion ≥60% in a major epicardial artery and 32.2% of patients had RCA chronic total occlusion. Right-to-left coronary collateralization was only identified in patients with obstructive stenosis in the LAD or LCx in addition to the LM stenosis.
Conclusion: Dedicated LM stent platforms may need to be developed to accommodate larger vessel size and bifurcation distributions. A majority of patients with LM stenosis will require adjunctive epicardial vessel PCI to achieve complete anatomic revascularization.     

Transseptal approach for stent implantation in right internal carotid artery stenosis

Carotid artery stenting is emerging as an effective measure to prevent strokes in patients with significant carotid artery stenosis. We report a case of right internal carotid artery stenosis in which we used a transseptal approach for successful carotid artery stenting. This patient had concomitant stenosis at all three coronary arteries, including the left main coronary artery. A transseptal approach was adopted due to the sharply angled take-off of the right brachiocephalic artery from the tortuous aortic arch, where advancement of an extra-stiff wire into the right common carotid artery was not possible by a femoral artery approach.     

冠状动脉粥样硬化狭窄与脑动脉粥样硬化狭窄的关系

目的探讨颈动脉和（或）脑动脉粥样硬化狭窄与冠状动脉狭窄的关系。方法选择34例心内科住院伴有脑缺血症状、接受冠状动脉造影并颈动脉造影或全脑血管造影的患者。根据造影动脉管腔狭窄的程度分别分成三个亚组,冠状动脉狭窄分为轻度狭窄组（5例）、中度狭窄组（4例）、重度狭窄组（25例）;脑血管狭窄分为轻度狭窄组（6例）、中度狭窄组（4例）、重度狭窄组（24例）。结果冠状动脉狭窄与颈动脉或椎动脉狭窄程度分布一致,冠状动脉血管重度狭窄者25例,脑血管重度狭窄者24例,二者间差异无统计学意义;冠状动脉Califf危险记分≥2分者,脑血管中、重度狭窄的比例高达92％,且随着冠状动脉狭窄程度的加重,颈动脉及脑血管狭窄的程度亦加重。随访发现中重度双重狭窄（冠状动脉狭窄同时伴有脑动脉狭窄）病变的心脑事件发生明显增多,其中双重度狭窄死亡3例。结论颈动脉或椎动脉粥样硬化性狭窄的发生率及程度与冠状动脉狭窄是平行的。故对冠状动脉狭窄合并颈动脉和（或）椎动脉粥样硬化狭窄者,尤其伴有高血压、糖尿病、吸烟等多重危险因素时,应给予积极强化的联合治疗以减少心脑血管事件的发生。     

颈动脉窦粥样硬化与冠状动脉粥样硬化程度相关

目的:探讨颈动脉粥样硬化与冠心病程度的关系。方法:对285例可疑冠心病患者行冠脉造影检查,以B型超声仪检查颈动脉内中膜厚度(IM T)。用冠脉病变支数表示冠心病程度。采静脉血检查血脂水平。结果:颈动脉与冠状动脉粥样硬化有共同的危险因子,如增龄、肥胖、血脂异常。比较各组IM T差别发现,颈动脉窦的F值最大(左,右分别为65.64%,63.24%)。颈动脉窦粥样硬化对诊断冠心病的阳性预告值最大(左、右颈动脉窦分别为89.9%,88.8%)。结论:颈动脉窦IM T与冠心病程度明显相关。颈动脉窦IM T可以作为筛选冠心病的指标。     

颈部血管彩超检查对缺血性脑血管病患者的临床意义

目的 探讨颈部血管彩超检查对缺血性脑血管病患者的临床意义.方法 以我院2011年1月-2012年1月收治的缺血性脑血管病患者30例为观察组,无缺血性脑血管病者30例为对照组,对两组患者进行颈部血管彩超检查,比较颈动脉粥样斑块发生率和颈动脉狭窄率.结果 观察组颈动脉粥样斑块发生率为100.0%,颈动脉狭窄发生率为60.0%;对照组颈动脉粥样斑块发生率为16.7%,颈动脉狭窄发生率为10.0%;观察组患者的颈动脉粥样斑块发生率及颈动脉狭窄发生率均明显高于对照组,差异有统计学意义(P＜0.05).结论 颈动脉血管彩超检查可早期发现颈动脉粥样硬化,及时了解颈动脉血管狭窄,对预防或治疗缺血性脑血管病具有重要的意义.     

Relationship of carotid intima-media thickness, pulse wave velocity, and ankle brachial index to the severity of coronary artery atherosclerosis

BACKGROUND: Carotid intima-media thickness (IMT), pulse wave velocity (PWV), and the ankle brachial index (ABI) are widely used noninvasive modalities for evaluating atherosclerosis. HYPOTHESIS: The aim of this study was to determine the relationship of carotid IMT, PWV, and ABI with the severity of coronary artery disease (CAD), expressed as the Gensini score, and the presence of coronary risk factors. METHODS: We examined 205 consecutive patients (mean age 65 +/- 12 years) who were clinically suspected of having CAD and were scheduled to undergo coronary angiography. Carotid intima-media thickness, brachial-ankle PWV (baPWV), and ABI were measured in all subjects before they underwent coronary angiography. RESULTS: Of the 205 patients, 124 patients were diagnosed as having CAD based on the presence of >50% stenosis in a major coronary artery; the remaining 81 patients did not have CAD. A relatively good correlation was obtained between carotid IMT and the Gensini score (R = 0.411, p < 0.0001), whereas baPWV correlated only weakly with the Gensini score (R = 0.203, p = 0.0035), and ABI did not correlate with it. A multiple regression analysis revealed that the Gensini score correlated significantly and independently with age, male gender, and carotid IMT. CONCLUSIONS: Of the three noninvasive methods, carotid IMT may be more useful for determining coronary artery atherosclerosis than baPWV or ABI.