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Carotid intima-media thickness in pre-and postmenopausal women with suspected coronary artery disease

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Abstract

Carotid intima-media thickness (CIMT) is an early marker of coronary artery disease (CAD). This study aimed to evaluate CIMT value for CAD prediction in pre-and postmenopausal women referred for coronary angiography with angina-like symptoms and a positive result of the treadmill test. The study comprised 321 women referred for coronary angiography with symptoms suggesting CAD. Carotid intima-media thickness was measured in common, bifurcation, and internal carotid artery, and expressed as the mean maximum value. Coronary angiography showed coronary stenosis ≥50% in 211 (65.7%) women, including 27 with regular menses (47.3 ± 3.4 years) and 184 postmenopausal (65.8 ± 7.2 years). Normal coronary arteries were found in 110 women: 17 (47.3 ± 4.9 years) with regular menses and 93 postmenopausal (64.3 ± 6.5 years). The highest CIMT values were found in postmenopausal CAD women (1.360 ± 0.32 mm), as compared to premenopausal with CAD (1.178 ± 0.36 mm, P = 0.005), pre-(0.860 ± 0.23 mm, P < 0.001) and postmenopausal (1.022 ± 0.30 mm, P < 0.001) women without CAD. Carotid intima-media thickness (P < 0.001), hyperlipidemia (P = 0.018), and myocardial infarction (P < 0.001), but not menopause itself or the number of years since menses cessation, were found to be independent CAD predictors. By receiver operating characteristic calculation, the mean maximum CIMT cut-off values discriminating CAD were lower in premenopausal (≥0.933 mm) than in postmenopausal women (≥1.075 mm; P < 0.05) resulting in similar sensitivity (85.2% and 82.6%) and specificity (70.6% and 69.9%). Carotid intima-media thickness is a strong CAD predictor in both pre-and postmenopausal women, in contrast to the menopausal status.

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Authors and Affiliations

  1. Department of Cardiac and Vascular Diseases, Institute of Cardiology, Collegium Medicum, Jagiellonian University, 31-202, Krakow, Poland

    Anna Kablak-Ziembicka, Tadeusz Przewlocki, Wieslawa Tracz, Piotr Pieniazek, Piotr Musialek, Rafal Drwila & Daniel Rzeznik

  2. Department of Statistics, Cracow University of Economics, Krakow, Poland

    Andrzej Sokolowski

Authors
  1. Anna Kablak-Ziembicka
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  2. Tadeusz Przewlocki
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  3. Wieslawa Tracz
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  4. Piotr Pieniazek
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  5. Piotr Musialek
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  6. Andrzej Sokolowski
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  7. Rafal Drwila
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  8. Daniel Rzeznik
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Correspondence to Anna Kablak-Ziembicka.

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Kablak-Ziembicka, A., Przewlocki, T., Tracz, W. et al. Carotid intima-media thickness in pre-and postmenopausal women with suspected coronary artery disease. Heart Vessels 23, 295–300 (2008). https://doi.org/10.1007/s00380-008-1044-y

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  • DOI: https://doi.org/10.1007/s00380-008-1044-y

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