Background: Coronary artery angiography is still the gold standard of choice for detection of coronary artery disease. Nevertheless, it is an invasive procedure and its complications are not uncommon. It also predisposes patients to the potential risks of contrast study and radiation

Objective: In the present report, we aimed to assess the significance of carotid intima-media thickness (CIMT) in patients undergoing coronary artery bypass grafting (CABG) by applying an imaging approach.

Patients and Methods: The carotid arteries were evaluated at baseline with high-resolution B-mode ultrasonography by a single trained physician. Measurements were performed on the far wall of the common carotid artery in a longitudinal view. Age-adjustment was done for the measured values before deciding regarding their appropriateness in each patient. Among 215 patients undergoing CABG, 70% had a higher CIMT above the expected normal range for their ages.

Results: In our study sample, 2/3 of CAD patients requiring coronary revascularization were male. In 70% of cases carotid artery had intimal-medial thickness of above the presumed age-adjusted reference range. Traditional risk factors including hyperlipidemia, hypertension, smoking, diabetes mellitus and family history although important, but did not accurately reflect presence or extension of progression of the atherosclerotic process which could be determined by CIMT measurement. The CIMT in these patients were mostly dependent on the number and severity of the risk factors.

Conclusions: High prevalence of the increased CIMT in patients undergoing CABG highlights the significance of CIMT measurement in early diagnosis of the systemic atherosclerosis. Moreover, although Traditional cardiovascular risk factors were important they could not explain the extension and the severity of CIMT. It seems that some ultrasonographic features such as the associated carotid plaques and their characteristics provide promising clues to detect existing atherosclerosis. More importantly, avoiding the misinterpretation age-adjustment should be considered in all patients.