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Brachial intima-media thickness is associated with coronary artery atherosclerosis in patients with diabetes mellitus

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Abstract

Coronary artery calcification (CAC) as measured by computed tomography is a strong predictor of coronary artery disease. The brachial intima-media thickness (IMT) was recently reported to be associated with cardiovascular risk factors. This study investigated the association of brachial IMT with CAC, which is a marker of coronary artery atherosclerosis, in patients with diabetes. We enrolled 292 patients with diabetes (mean age, 65 ± 12 years; 59% men) who underwent both endothelial function testing and computed tomography for risk assessment of coronary artery disease. Flow-mediated dilation (FMD) and IMT in the brachial artery were measured with a specialized machine. FMD was lower and brachial IMT was thicker in patients with than without CAC. The CAC score was significantly correlated with both brachial IMT and FMD, while the multivariate logistic analysis demonstrated that brachial IMT (> 0.32 mm) but not FMD (< 5.1%) was significantly associated with the presence of CAC (odds ratio, 2.03; 95% confidence interval, 1.10–3.77; p = 0.02). The receiver operating characteristic curve analysis showed that the area under the curve for discriminating patients with CAC was 0.67 for IMT (p < 0.001) and 0.62 for FMD (p < 0.001). When patients were classified into four groups based on brachial IMT and FMD, the CAC score was higher in patients with thicker brachial IMT and lower FMD than in patients of the other groups (p < 0.001). Measurement of brachial IMT could be useful for the risk assessment of patients with diabetes.

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Acknowledgment

The authors thank Angela Morben, DVM, ELS, from Edanz Group (http://www.edanzediting.com/ac), for editing a draft of this manuscript.

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Authors and Affiliations

  1. Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 7008558, Japan

    Tamaki Ono, Toru Miyoshi, Kazuhiro Osawa, Yoichi Takaya, Takashi Miki, Keishi Ichikawa & Hiroshi Ito

  2. Department of Medical Technology, Kawasaki College of Allied Health Professions, Kurashiki, Japan

    Yuko Ohno

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  1. Tamaki Ono
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  2. Toru Miyoshi
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Correspondence to Toru Miyoshi.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (ethics committees of Okayama University Hospital and Okayama City Hospital) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The first and last authors take complete responsibility for the integrity of the data and the accuracy of the data analysis.

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Ono, T., Miyoshi, T., Ohno, Y. et al. Brachial intima-media thickness is associated with coronary artery atherosclerosis in patients with diabetes mellitus. Heart Vessels 34, 1405–1411 (2019). https://doi.org/10.1007/s00380-019-01371-8

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  • DOI: https://doi.org/10.1007/s00380-019-01371-8

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