evidence that acute phase reactants, especially C-reactive protein, are not just the markers of inflammation but also active participants of the formation process of atherosclerotic plaques (Zwaka et al 2001; Fu and Borensztajn 2002). Clinical implications A high prevalence of carotid disease in patients with CAD and the associated risks imply that screening for carotid atherosclerosis should be considered in all patients with diagnosed CAD. The detection of carotid disease may modify treatment strategy of these patients; eg, more aggressive medical therapy in case of subclinical carotid atherosclerosis, combined coronary and carotid surgery for patients with critical stenoses in both territories, and staged operations. Conclusions 1. Intima-media thickness may be used for cardiovascular risk assessment in patients at intermediate risk of CAD. 2. 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