Background: Coronary calcium score (CCS) on MDCT and carotid intima-media thickness (IMT) have been widely used as indices of atherosclerosis. However, the clinical correlation between carotid IMT and the severity of coronary artery disease (CAD) is relatively poorly established. CCS on MDCT compares favorably with carotid IMT as a noninvasive index of prevalent CAD. The aim of this study was to analysis the relationship between coronary in-stent restenosis (ISR) after Drug-eluting stent (DES) implantation and a CCS or carotid IMT. Methods: Among a total of 3712 patients who undergone carotid ultrasonography, 1073 patients (1533 lesions) (mean age=61.7±10.3 years) who had undergone follow-up coronary angiography (CAG) after DES implantation were divided into two groups. Group 1 (n=860, male=64.2%) was the no ISR group. Group 2 (n=213, male=59.2%) was the ISR group. ISR was defined as a more than 50% reduction in luminal stent diameter on follow-up CAG. We ananlysis the relationship between CCS and carotid IMT and predictors of ISR were identified by multivariate logistic regression analyses
Results: On comparison between the two groups (group 1 vs group 2), There was no significant difference in the right and left maximal IMT, mean IMT, medial thickness or intima thickness. CCS was significantly higher on MDCT in the ISR group (377.79±523.56 vs. 1115.40±1043.74, p <0.001). In the correlation analysis between CCS and carotid IMT, only Left carotid IMT showed weakly correlation with CCS (p=0.008, γ=0.255). On multivariate analysis, the CCS on MDCT (odds ratio 1.001, p=0.002, 95% CI: 1.000-1.002) and Stent length (odds ratio 1.057, p=0.002, 95% CI: 1.020-1.094) were the significant predictors of coronary artery ISR. CCS of cut-off value with 60% sensitivity and 80% specificity was 668.5. Conclusion: The CCS and stent length are significant predictive markers for ISR after DES implantation when compared to the carotid IMT. Noninvasive measurement of the CCS might be useful for prediction and evaluation of coronary restenosis after DES implantation.
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