PREDICTIVE UTILITY OF CAROTID ARTERY ULTRA'SONOGRAPHY IN IDENTIFYING RISK FOR CORONARY ARTERY ATHEROSCLEROTIC DISEASE: A STUDY IN THE PAKISTANI POPULATION

Abstract

Carotid artery ultrasonography is a non-invasive, cost-effective, nonradioactive imaging technique that allows for the visualization and measurement of the carotid arteries.  Objective: To detemtine the sensitivity, specificity, and positive predictive value of carotid artery ultrasound using both B mode and doppler ultrasound, in predicting the presence of significant coronary artery disease in a cohod of Pakistani adults.  Methods: It’s a cross sectional study that was held at Department of Radiology, CMH, Malir-Karachi, that enrolled 103 patients through non-probability consecutive sampling. After informed consent, demographic details of all patients were documented. Both males and females were enrolled having cardiac symptoms with age ranging from 35-75years were enrolled. However, patients with prior history of coronary intervention (PCI, CABG) or diagnosed case of coronary artery disease were excluded.  All the data was processed by SPSS v28.0. Quantitative variables were presented as mean ± SD. Qualitative variables was presented as frequencies and percentages. Evaluation among groups according to Fisher's exact and chi-square tests were applied with p-value of ≤0.05 was taken significant. Results: Mean age of the patients was 48.4 ± 10.3 years. The mean CIMT was 0.83 ± 0.12 mm. The diagnostic performance of carotid ultrasound in detecting significant CAD showed a sensitivity of 85.0%, specificity of 65.1%, accuracy of 76.7%, PPV of 77.3%, and NPV of 75.7%.  Conclusion: We concluded that carotid artery ultrasound is an accurate, highly sensitive, non-invasive imaging investigation for detecting coronary artery disease with low specificity.