Objective: Currently, patients are sent to coronary angiography based on clinical presentation, positive exercise testing and assessment of global cardiovascular risk with particular emphasis on early detection of organ damage. Aim of our study was to evaluate the potential of a complete vascular ultrasound examination to estimate the actual presence of plaque on coronaries.

Design and method: In 163 in-patients with a clinical indication for coronary angiography (CA), we obtained: blood pressures (BP), creatinine (Cr) and glycaemia (G) values, a complete transthoracic echocardiography with measure of Doppler velocity in proximal anterior descending coronary (vLAD), and carotid IMT and PWV (Esaote gold 70). We then divided the group in G1 (N=96) (patients with at least one significant coronary stenosis), and G2 (N=67) (unaffected coronaries).

Results: G1 and G2 had similar ages (66±11vs65±10yrs, means±SD), BMI (26±4vs27±4g/m2) and diastolic BP (80±10vs78±9mmHg, p=NS), while G1 showed higher systolic BP (135±20vs127±17mmHg,p<0.05), blood G (119±42vs104±35mg/dl, p<0.05), Cr (1.04±0.48vs0.85±0.17mg/dl, p<0.01), carotid IMT (811±163vs711±153um, p<0.001), carotid PWV (10±2.61vs8.87±2.39, p<0.05), and vLAD (64±38vs41±10cm/sec, p<0.0001). The variables that showed a correlation with the number of affected vessels were: blood G(r=0.21, p<0.01), Cr (r=0.23, p<0.005), IMT (r=0.25, p<0.01), and vLAD (r=0.4, p<0.0001).

Conclusions: These preliminary results suggest that peripheral artery structure and function assessed non invasively are representative of coronary status. Moreover transthoracic Doppler flow assessed on proximal LAD is well correlated with the presence and the number of affected coronaries. A complete ultrasound and clinic evaluation help in the decision making process of the coronary patient.