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Atherosclerosis is the most common cause of mortality and morbidity in the world. Estimation of the existence of atherosclerotic coronary artery disease before clinically presentation is very important for cardiovascular risk evaluation. Coronary calcium score (CCS), carotid intima-media thickness (CIMT) and pregnancy associated plasma protein-A (PAPP-A) are predictors for the development of atherosclerosis. In this study it was aimed to investigate the relationship between CCS, CIMT and PAPP-A for diagnosing atherosclerosis earlier.
Ninety-nine patient having multi-detected computerized tomography (MDCT) between December 2011 and December 2012 were included in study. All patients were selected from individuals who underwent MDCT in our hospital with a suspicion of coronary artery disease. The levels of the CCS, CIMT and PAPP of the patients were calculated. Demographic properties, whether or not having risk factors of atherosclerosis and the laboratory parameters of the study patients have been recorded.
25 women (%25,3), 74 men (%74,7) were admitted to our study. The mean age was 52,8±13,1. In forty-three patients (%43,4), atherosclerotic plague were detected in carotid artery. The presence of carotid artery plague (CAP) were associated the existence of coronary artery disease (CAD) (p<0,001). The occurrence of CAP were more frequent in patients with diabetes mellitus and hypertension compared without them (consequently p<0,001; p=0,003). PAPP-A, CCS and CIMT values were also higher in patients with diabetes and hypertension. A significant correlation between PAPP-A and CCS (p<0,001), moderate correlation between CCS and CIMT were observed (p<0,001). Grading the CAD of patients according to MDCT, the optimal cut-off point of PAPP-A in detecting CAD was 2,35 ng/ml with 94,3% sensitivity and 68,3% specificity the optimal cut-off point of right and left CIMT in detecting CAD was 0,6 mm with 75% sensitivity and 87,3% specificity for right CIMT and with 75% sensitivity and 79,4% specificity for left CIMT.
Our study showed that levels of CIMT, CCS, PAPP-A were associated in patient with subclinical and obvious CAD. The values of PAPP-A, CCS, and CIMT have been found higher in patients who has traditional atherosclerotic risk factors.
Accordingly, we concluded that it is proper to use the parameters of PAPP-A, CCS and CIMT in investigating the subclinical atherosclerosis and in guiding treatment. However in order to have more precise cut-off points, larger studies must be carried on.