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Updated: Jul 31, 2026
A Methodological Approach to Non-invasive Assessments of Vascular Function and Morphology
Published on: February 7, 2015
The 'CARFEM' vascular index as a predictor of coronary atherosclerosis
Philip Claessens1, Christophe Claessens, Marc Claessens
1Department of Cardiology, Hospital Sint Jan, Brugge, Belgium.
Insights
Non-invasive carotid and peripheral artery scans can detect coronary atherosclerosis severity. The CARFEM index aids in differentiating coronary artery disease severity non-invasively.
Area of Science:
- Cardiovascular Medicine
- Vascular Biology
- Diagnostic Imaging
Background:
- Coronary atherosclerosis poses a significant health risk.
- Non-invasive methods are crucial for early detection and risk stratification.
- Assessing peripheral and carotid arteries may offer insights into coronary health.
Purpose of the Study:
- To detect coronary atherosclerosis non-invasively.
- To identify individuals at risk for coronary artery disease.
- To evaluate the utility of carotid and peripheral artery examinations for risk assessment.
Main Methods:
- Vascular duplex scans were used to measure intima-media thickness (IMT) of the common carotid artery in 366 patients.
- Patients were categorized into four groups based on coronary artery stenosis severity.
- The CARFEM index, combining carotid IMT and femoral artery wall thickness, was developed to assess atherosclerotic burden.
Main Results:
- Significant differences in common carotid artery IMT were observed between patients with normal coronary arteries and those with three-vessel coronary disease.
- The CARFEM index effectively differentiated between normal coronary arteries and critical three-vessel disease.
- The CARFEM index demonstrated potential in distinguishing between various subgroups of coronary artery disease severity.
Conclusions:
- Intima-media thickness of the common carotid artery is a reliable non-invasive marker for detecting and predicting coronary atherosclerosis severity.
- Combined assessment of carotid and femoral arterial walls using the CARFEM index enhances the ability to differentiate coronary atherosclerosis subgroups.
Background:
The purpose of the study was detection of coronary atherosclerosis and identification of persons at risk by means of non-invasive examination of the carotid and peripheral arteries.
Material/Methods:
Investigation of 366 patients: 229 males and 137 females divided into groups according to age and the severity of the coronary atherosclerotic lesions. Only patients with a coronary stenosis of more than 90%, who needed angioplasty or coronary bypass surgery, were included. Group I consisted of patients with normal coronary arteries; Group II, critical one-vessel disease; Group III, two-vessel disease; Group IV, critical three-vessel disease. By means of a vascular duplex scan we measured bilaterally the intima-media thickness of the posterior wall of the common carotid artery. In order to provide a more accurate estimation of the total atherosclerotic burden we have created the 'CARFEM' index (combination index of intima media thickness of carotid artery and total wall thickness of the superficial femoral artery).
Results:
The anthropometric data were identical among the different groups. There are statistically highly significantly differences in the intima-media thickness of the common carotid artery when patients with normal coronary arteries are compared with patients with three-vessel coronary disease. By calculating the 'CARFEM' index not only we can differentiate between patients with normal coronary arteries and patients with critical three-vessel disease, but there are also ways to differentiate between different subgroups and to assess possible one-vessel, two-vessel or three-vessel coronary artery disease.
Conclusions:
The determination of the intima-media thickness of the common carotid artery clearly enables us to detect possible coronary atherosclerosis and to predict its severity in a non-invasive way. The combined assessment of the carotid and the femoral arterial walls permits us to make a distinction between the different subgroups, divided according to the severity of the underlying coronary atherosclerosis.
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