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Verteilung der karotidalen Intima-Media-Dicke bei Männern und Frauen mit und ohne koronare Herzerkrankung

Querschnittsdaten aus der Heinz Nixdorf Recall Studie

Distribution of carotid intima media thickness in men and women with and without coronary heart disease

Cross-sectional data of the Heinz Nixdorf Recall Study

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Zusammenfassung

Ziel

Ziel ist die Deskription populationsbasierter geschlechts- und altersstratifizierter Daten der karotidalen Intima-Media-Dicke (CIMT)-Verteilung sowie der Vergleich fixer Cut-off- und Perzentilenwerte für Personen mit und ohne koronare Herzerkrankung (KHK) und die Deskription von CIMT-Perzentilen.

Methoden

Zwischen 2000 und 2003 wurden 4.814 Teilnehmer zwischen 45 und 75 Jahren in die Heinz Nixdorf Recall Studie (HNR) rekrutiert. Die Ultraschalluntersuchung wurde an den extrakraniellen Gefäßen durchgeführt und die CIMT manuell 1 cm proximal des Bulbus der Arteria carotis communis (ACC) auf beiden Seiten gemessen und der Mittelwert herangezogen.

Ergebnisse

Die CIMT konnte für 1.749 Männer und 1.802 Frauen ohne und 177 Männer und 50 Frauen mit vorbekannter KHK gemessen werden. Die mittlere CIMT war bei Männern höher als bei Frauen (Männer 0,71±0,14 mm vs. Frauen 0,65±0,11 mm, p<0,0001) und auch bei Probanden mit KHK gegenüber denen ohne KHK erhöht (Männer mit und ohne KHK: 0,76±0,14 mm und 0,70±0,14 mm, p<0,0001; Frauen mit und ohne KHK: 0,73±0,15 mm und 0,64±0,11 mm, p<0,0001). Bei Männern stieg die mittlere CIMT von 0,62±0,10 mm in der jüngsten (45–49 Jahre) bis auf 0,79±0,13 mm in der ältesten Altersgruppe (≥70 Jahre), bei Frauen von 0,57±0,08 mm bis auf 0,71±0,12 mm (p<0,0001 für beide).

Schlussfolgerung

Wir berichten über CIMT-Verteilungen mit hoher Übereinstimmung verglichen mit internationalen Studien. Besonders bei älteren Teilnehmern beobachteten wir allerdings niedrigere CIMT-Werte, was auf den Ausschluss karotidaler Plaque-Formationen bei der CIMT-Messung zurückgeführt werden kann.

Abstract

Purpose

The aim of this study was to introduce population-based sex and age-stratified distributions of carotid intima media thickness (CIMT), to compare fixed cut-off and percentile values for subjects with and without known coronary heart disease (CHD) and to describe CIMT percentiles.

Methods

Between 2000 and 2003, a total of 4,814 subjects aged 45–75 years were recruited into the Heinz Nixdorf recall study (HNR). Ultrasound examination of extracranial arteries was performed and the CIMT was measured manually over a distance of 1 cm proximal to the bulb in the common carotid artery (CCA). Both sides were measured and the average of the right and left artery were calculated (mean CIMT).

Results

The CIMT was measured for 1,749 men and 1,802 women without prevalent CHD and 177 men and 50 women with prevalent CHD. Mean CIMT values were higher in men compared to women (men 0.71 ± 0.14 mm vs. women 0.65 ± 0.11 mm, p ≤ 0.0001) and in subjects with CHD compared to those without (men with and without CHD: 0.76 ± 0.14 mm and 0.70 ± 0.14 mm, p ≤ 0.0001, respectively; women with and without CHD: 0.73 ± 0.15 mm and 0.64 ± 0.11 mm, p ≤ 0.0001, respectively). In men the mean CIMT increased from 0.62 ± 0.10 mm in the youngest (45–49 years old) up to 0.79 ± 0.13 mm in the highest age group (≥ 70 years) (0.57 ± 0.08 mm up to 0.71 ± 0.12 mm in women, p ≤ 0.0001 for both).

Conclusions

Compared to international studies similar CIMT distributions were found in this study using both continuous and percentile distributions. However, lower CIMT values were observed in older participants, which can be explained by exclusion of carotid plaque formation in CIMT measurements.

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Literatur

  1. Bauer M, Möhlenkamp S, Erbel R (2009) Intima-media thickness is a suitable surrogate marker for systemic atherosclerosis – pro. Dtsch Med Wochenschr 134:2006

    Article  PubMed  CAS  Google Scholar 

  2. Adams MR, Nakagomi A, Keech A et al (1995) Carotid intima-media thickness is only weakly correlated with the extent and severity of coronary artery disease. Circulation 92:2127–2134

    Article  PubMed  CAS  Google Scholar 

  3. Stensland-Bugge E, Bønaa KH, Joakimsen O (2001) Age and sex differences in the relationship between inherited and lifestyle risk factors and subclinical carotid atherosclerosis: the Tromsø study. Atherosclerosis 154:437–448

    Article  PubMed  CAS  Google Scholar 

  4. Zureik M, Touboul PJ, Bonithon-Kopp C et al (1999) Cross-sectional and 4-year longitudinal associations between brachial pulse pressure and common carotid intima-media thickness in a general population. The EVA study. Stroke 30:550–555

    Article  PubMed  CAS  Google Scholar 

  5. Bauer M, Möhlenkamp S, Lehmann N et al (2009) The effect of age and risk factors on coronary and carotid artery atherosclerotic burden in males – results of the Heinz Nixdorf Recall Study. Atherosclerosis 205:595–602

    Article  PubMed  CAS  Google Scholar 

  6. O’Leary DH, Polak JF, Kronmal RA et al (1999) Carotid artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults. Cardiovascular Health Study Collaborative Research Group. N Engl J Med 340:14–22

    Article  Google Scholar 

  7. Bots ML, Hoes AW, Koudstaal PJ et al (1997) Common carotid intima-media thickness and risk of stroke and myocardial infarction: the Rotterdam Study. Circulation 96:1432–1437

    Article  PubMed  CAS  Google Scholar 

  8. Lorenz MW, Markus HS, Bots ML et al (2007) Prediction of clinical cardiovascular events with carotid intima-media thickness: a systematic review and meta-analysis. Circulation 115:459–467

    Article  PubMed  Google Scholar 

  9. Villines TC, Stanek EJ, Devine PJ et al (2010) The ARBITER 6-HALTS Trial (Arterial Biology for the Investigation of the Treatment Effects of Reducing Cholesterol 6-HDL and LDL Treatment Strategies in Atherosclerosis): final results and the impact of medication adherence, dose, and treatment duration. J Am Coll Cardiol 55:2721–2726

    Article  PubMed  Google Scholar 

  10. Taylor AJ, Villines TC, Stanek EJ et al (2009) Extended-release niacin or ezetimibe and carotid intima-media thickness. N Engl J Med 361:2113–2122

    Article  PubMed  CAS  Google Scholar 

  11. Pignoli P, Tremoli E, Poli A et al (1986) Intimal plus medial thickness of the arterial wall: a direct measurement with ultrasound imaging. Circulation 74:1399–1406

    Article  PubMed  CAS  Google Scholar 

  12. Stein JH, Korcarz CE, Hurst RT et al (2008) Use of carotid ultrasound to identify subclinical vascular disease and evaluate cardiovascular disease risk: a consensus statement from the American Society of Echocardiography Carotid Intima-Media Thickness Task Force. Endorsed by the Society for Vascular Medicine. J Am Soc Echocardiogr 21:93–111

    Article  PubMed  Google Scholar 

  13. Touboul PJ, Hennerici MG, Meairs S et al (2007) Mannheim carotid intima-media thickness consensus (2004–2006). An update on behalf of the Advisory Board of the 3rd and 4th Watching the Risk Symposium, 13th and 15th European Stroke Conferences, Mannheim, Germany, 2004, and Brussels, Belgium, 2006. Cerebrovasc Dis 23:75–80

    Article  PubMed  Google Scholar 

  14. Chambless LE, Folsom AR, Clegg LX et al (2000) Carotid wall thickness is predictive of incident clinical stroke: the Atherosclerosis Risk In Communities (ARIC) study. Am J Epidemiol 151:478–487

    Article  PubMed  CAS  Google Scholar 

  15. Salonen JT, Salonen R (1991) Ultrasonographically assessed carotid morphology and the risk of coronary artery disease. Arterioscler Thromb 11:1245–1249

    Article  PubMed  CAS  Google Scholar 

  16. Naghavi M, Falk E, Hecht HS et al (2006) From vulnerable plaque to vulnerable patient – part III: Executive summary of the Screening for Heart Attack Prevention and Education (SHAPE) Task Force Report. Am J Cardiol 98:2H–15H

    Article  PubMed  Google Scholar 

  17. Lester SJ, Eleid MF, Khandheria BK, Hurst RT (2009) Carotid intima-media thickness and coronary artery calcium score as indications of subclinical atherosclerosis. Mayo Clin Proc 84:229–233

    Article  PubMed  Google Scholar 

  18. Schmermund A, Möhlenkamp S, Stang A et al (2002) Assessment of clinically silent atherosclerotic disease and established and novel risk factors for predicting myocardial infarction and cardiac death in healthy middle-aged subjects: rationale and design of the Heinz Nixdorf RECALL Study. Risk Factors, Evaluation of Coronary Calcium and Lifestyle. Am Heart J 144:212–218

    Article  PubMed  Google Scholar 

  19. Erbel R, Möhlenkamp S, Moebus S et al (2010) Coronary risk stratification, discrimination, and reclassification improvement based on quantification of subclinical coronary atherosclerosis: the Heinz Nixdorf recall study. J Am Coll Cardiol 56:1397–1406

    Article  PubMed  Google Scholar 

  20. Erbel R, Möhlenkamp S, Jöckel KH et al (2008) Cardiovascular risk factors and signs of subclinical atherosclerosis in the Heinz Nixdorf Recall Study. Dtsch Arztebl Int 105:1–8

    PubMed  Google Scholar 

  21. Möhlenkamp S, Moebus S, Schmermund A et al (2007) Assessment of the natural history of coronary artery calcification and identification of its determinants. Rationale of the 2nd part of the Heinz Nixdorf Recall Study. Herz 32:108–120

    Article  PubMed  Google Scholar 

  22. Heiss G, Sharrett AR, Barnes R et al (1991) Carotid atherosclerosis measured by B-mode ultrasound in populations: associations with cardiovascular risk factors in the ARIC study. Am J Epidemiol 134:250–256

    PubMed  CAS  Google Scholar 

  23. Raitakari OT, Juonala M, Kähönen M et al (2003) Cardiovascular risk factors in childhood and carotid artery intima-media thickness in adulthood: the Cardiovascular Risk in Young Finns Study. JAMA 290:2277–2283

    Article  PubMed  CAS  Google Scholar 

  24. Bauer M, Mahabadi AA, Kälsch H et al (2012) Status quo et quo vadis? Intima-Media-Dickenmessung. Cardiovasc 2:62–68

    Article  Google Scholar 

  25. Wendelhag I, Liang Q, Gustavsson T, Wikstrand J (1997) A new automated computerized analyzing system simplifies readings and reduces the variability in ultrasound measurement of intima-media thickness. Stroke 28:2195–2200

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Klinik für Kardiologie, Westdeutsches Herzzentrum Essen, Universitätsklinikum Essen, Universität Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Deutschland

    M. Bauer, S. Möhlenkamp, H. Kälsch, A.A. Mahabadi, K. Kara & R. Erbel *

  2. Leibniz-Institut für umweltmedizinische Forschung, Heinrich-Heine-Universität Düsseldorf, und Medizinische Fakultät der Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland

    B. Hoffmann

  3. Abteilung für Kardiologie, Krankenhaus Bethanien, Moers, Deutschland

    S. Möhlenkamp

  4. Institut für Medizinische Informatik, Biometrie und Epidemiologie, Universitätsklinikum Essen, Universität Duisburg-Essen, Essen, Deutschland

    N. Lehmann, S. Moebus, U. Roggenbuck & K.-H. Jöckel

  5. Klinik für Angiologie, Universitätsklinikum Essen, Universität Duisburg-Essen, Essen, Deutschland

    C. Berg

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  1. M. Bauer
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  2. B. Hoffmann
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  3. S. Möhlenkamp
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  4. N. Lehmann
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  5. S. Moebus
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  7. C. Berg
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  8. H. Kälsch
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  9. A.A. Mahabadi
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  10. K. Kara
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  11. K.-H. Jöckel
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  12. R. Erbel *
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Correspondence to M. Bauer.

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* on behalf of the Heinz Nixdorf Recall Study investigators

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Bauer, M., Hoffmann, B., Möhlenkamp, S. et al. Verteilung der karotidalen Intima-Media-Dicke bei Männern und Frauen mit und ohne koronare Herzerkrankung. Herz 38, 501–508 (2013). https://doi.org/10.1007/s00059-012-3718-6

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  • DOI: https://doi.org/10.1007/s00059-012-3718-6

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