Objectives Carotid intima-media thickness (CIMT) is surrogate marker of atherosclerosis and associated with coronary artery disease. We evaluated CIMT in patients with coronary atherosclerosis according to the clinical diagnosis; Stable angina, acute coronary syndrome (ACS) except ST-elevated myocardial infarction (STEMI), and STEMI. Methods Study subjects consisted of 974 consecutive patients (525 males, mean 59.8±11.3 years old) who underwent coronary angiogram. CIMT was measured using high-resolution ultrasound at both common carotid arteries. Study subjects were divided into 4 group; control group (n=364, 35.5%) who did not have significant stenosis (> 50% diameter stenosis), stable angina group (n=390, 40.0%), unstable angina plus NSTEMI group (n=136, 14.0%), and STEMI group (n=102, 10.5%). Results Control group is younger than angina and unstable angina plus NSTEMI group (58.3±11.3yrs vs. 60.7±10.3yrs and 61.6±10.9yrs, p=0.035 and p=0.034, respectively) and had lower fasting blood sugar level than unstable angina plus NSTEMI group (104.2±27.0mg/dL vs. 119.7±38.6mg/dL, p<0.001) and STEMI group (104.2±27.0mg/dL vs. 130.1±45.4mg/dL, p<0.001). STEMI group had higher hs-CRP (4.74±5.68mg/dL vs. 2.32±3.00mg/dL, 2.49±2.92mg/dL and 2.31±2.90mg/dL, p<0.001, p<0.001 and p<0.001, respectively) and lower ejection fraction than control, stable angina and unstable angina plus NSTEMI grroup (55.6±13.3% vs. 67.2±8.5%, 66.1±9.3% and 64.7±10.0%, p<0.001, p<0.001, and p<0.001, respectively). CIMT was thicker in angina and unstable angina plus NSTEMI group than control group (0.85±0.23mm and 0.92±0.26mm vs. 0.81±0.18mm, p=0.035 and p<0.001, respectively), whereas those in STEMI group did not show any significant difference with those in control group (0.83±0.21mm vs. 0.81±0.18mm , p=NS). Conclusion CIMT in patients with STEMI was not significantly increased compared to those in other coronary artery disease group. This study suggests that STEMI can be developed in less severe atherosclerotic disease state.
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