Background: Coronary artery calcium score (CACS) and carotid intima-media thickness (CIMT) are considered important markers for early detection of coronary atherosclerosis. The study aimed to investigate the relation between the CIMT and the CACS as markers for atherosclerotic coronary artery disease (CAD).

Methods: This was a single-center prospective study that enrolled 41 cases with suspected CAD. The cases underwent detailed history-taking and clinical examination, then were assigned for carotid artery US and non-contrast CT (NCCT) of coronary arteries. A radiologist with 8 years-experience in vascular US imaging performed the carotid artery US, while two radiologists with 10 years-experience in cardiac imaging analyzed the coronary artery CT images and then assigned a CAC-DRS category for each case. The receiver operating characteristics (ROC) curve was used to estimate the best cutoff value of CIMT in predicting coronary artery heavy calcification.

Results: The study included 41 cases of suspected CAD, of which 12 showed heavy and 29 showed non-heavy coronary artery calcification. The mean CACS was 163, and the highest CIMT was 0.785 mm among the included patients. There was a significant positive correlation between the CACS and the highest CIMT (r 0.606 and P <0.001). A CIMT > 0.8 mm was the best cutoff for predicting heavy calcification, with a sensitivity of 91.7%, a specificity of 65.5%, and an accuracy of 73.2% based on ROC curve analysis.

Conclusions: CIMT and CACS can be considered non-invasive predictive measures for CA atherosclerosis and subsequent CAD. Moreover, these markers might help cardiologists in clinical management.