Skip to main content
Log in

Common Carotid Intima-media Thickness in Peripheral Arterial Disease

  • Original Articles
  • Published:
International Journal of Angiology

Abstract

The common carotid intima-media thickness (IMT) is regarded as a reliable predictor of cardiovascular morbidity. Patients with peripheral arterial disease (PAD) have an increased risk of cardiovascular morbidity and mortality, and PAD is associated with increases in IMT. The aim of this study was to establish whether IMT would be a suitable parameter for predicting cardiovascular risk in individual patients with PAD and the factors involved in determining IMT in these patients. This prospective study included 314 subjects: 112 patients with isolated PAD, 85 patients with PAD and additional coronary and/or cerebrovascular atherosclerosis, and 117 subjects without atherosclerotic disease. Maximum IMT (mIMT) was measured using high-resolution B-mode ultrasonography. Patients with isolated PAD were examined for influencing factors on mIMT. The mIMT in patients with isolated PAD (1.01 ± 0.2 mm) was not significantly different from that of patients with PAD and additional systemic atherosclerosis (1.01 ± 0.17 mm). Controls showed a significantly lower mIMT (0.71 ± 0.15 mm). In multivariate stepwise regression analysis, the chief influencing factors on mIMT in patients with isolated PAD included age as well as fasting insulin and plasminogen activator inhibitor-1 (PAI-1). We found significant correlations between mIMT and the presence of microalbuminuria in nondiabetics with PAD. The highly increased mIMT values of patients with isolated PAD reflect the elevated cardiovascular risk which is already present in the early clinical stages of PAD. The links between fasting insulin, PAI-1, microalbuminuria, and older age with mIMT in isolated PAD are at the same time important predictors of the development of systemic atherosclerosis in PAD.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. P Pignoli E Tremoli A Poli P Oreste R Paoletti (1986) ArticleTitleIntimal plus medial thickness of the arterial wall: A direct measurement with ultrasound imaging Circulation 74 1399–1406 Occurrence Handle1:STN:280:BiiD2M3gslU%3D Occurrence Handle3536154

    CAS  PubMed  Google Scholar 

  2. ML Bots AW Hoes PJ Koudstaal A Hofman DE Grobbee (1997) ArticleTitleCommon carotid intima-media thickness and risk of stroke and myocardial infarction: The Rotterdam study Circulation 96 1432–1437 Occurrence Handle1:STN:280:ByiH2Mbls1w%3D Occurrence Handle9315528

    CAS  PubMed  Google Scholar 

  3. LE Chambless AR Folsom AR Sharrett P Sorlie D Couper M Szklo FJ Nieto (2003) ArticleTitleCoronary heart disease risk prediction in the atherosclerosis risk in communities (ARIC) study J Clin Epidemiol 56 880–890 Occurrence Handle10.1016/S0895-4356(03)00055-6 Occurrence Handle14505774

    Article  PubMed  Google Scholar 

  4. LE Chambless G Heiss AR Folsom W Rosamond M Szklo AR Sharrett LX Clegg (1997) ArticleTitleAssociation of coronary heart disease incidence with carotid arterial wall thickness and major risk factors: The atherosclerosis risk in communities (ARIC) study, 1987–1993 Am J Epidemiol 146 483–494 Occurrence Handle1:STN:280:ByiH3srosVY%3D Occurrence Handle9290509

    CAS  PubMed  Google Scholar 

  5. M Hollander AE Hak PJ Koudstaal ML Bots DE Grobbee A Hofman JC Witteman MM Breteler (2003) ArticleTitleComparison between measures of atherosclerosis and risk of stroke: The Rotterdam study Stroke 34 2367–2372 Occurrence Handle10.1161/01.STR.0000091393.32060.0E Occurrence Handle1:STN:280:DC%2BD3svmsVSrug%3D%3D Occurrence Handle12958327

    Article  CAS  PubMed  Google Scholar 

  6. DH O’Leary JF Polak RA Kronmal TA Manolio GL Burke SK Wolfson SuffixJr (1999) ArticleTitleCarotid-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 Occurrence Handle10.1056/NEJM199901073400103 Occurrence Handle1:STN:280:DyaK1M%2FptVyksw%3D%3D Occurrence Handle9878640

    Article  CAS  PubMed  Google Scholar 

  7. JT Salonen R Salonen (1993) ArticleTitleUltrasound B-mode imaging in observational studies of atherosclerotic progression Circulation 87 IssueIDSuppl 1156–1165

    Google Scholar 

  8. ML Bots DE Grobbee (2002) ArticleTitleIntima media thickness as a surrogate marker for generalised atherosclerosis Cardiovasc Drug Ther 16 341–351 Occurrence Handle10.1023/A:1021738111273

    Article  Google Scholar 

  9. PL Allan PI Mowbray AJ Lee FG Fowkes (1997) ArticleTitleRelationship between carotid intima-media thickness and symptomatic and asymptomatic peripheral arterial disease. The Edinburgh Artery Study Stroke 28 348–353 Occurrence Handle1:STN:280:ByiC1MzgvFI%3D Occurrence Handle9040688

    CAS  PubMed  Google Scholar 

  10. GL Burke GW Evans WA Riley AR Sharrett G Howard RW Barnes W Rosamond RS Crow PM Rautaharju G Heiss (1995) ArticleTitleArterial wall thickness is associated with prevalent cardiovascular disease in middle-aged adults The Atherosclerosis Risk in Communities (ARIC) Study. Stroke 26 386–391 Occurrence Handle1:STN:280:ByqC1M3psl0%3D

    CAS  Google Scholar 

  11. KS Cheng A Tiwari CR Baker R Morris G Hamilton AM Seifalian (2002) ArticleTitleImpaired carotid and femoral viscoelastic properties and elevated intima-media thickness in peripheral vascular disease Atherosclerosis 164 113–120 Occurrence Handle10.1016/S0021-9150(02)00042-4 Occurrence Handle1:CAS:528:DC%2BD38Xlt12lt7w%3D Occurrence Handle12119200

    Article  CAS  PubMed  Google Scholar 

  12. R Caterina ParticleDe G Basta G Lazzerini G Dell’Omo R Petrucci M Morale F Carmassi R Pedrinelli (1997) ArticleTitleSoluble vascular cell adhesion molecule-1 as a biohumoral correlate of atherosclerosis Arterioscl Thromb Vasc Biol 17 2646–2654 Occurrence Handle9409238

    PubMed  Google Scholar 

  13. PC Simons A Algra ML Bots JD Banga DE Grobbee Y Graaf Particlevan der (1999) ArticleTitleCommon carotid intima-media thickness in patients with peripheral arterial disease or abdominal aortic aneurysm: The SMART study Second manifestations of arterial disease. Atherosclerosis 146 243–248 Occurrence Handle10.1016/S0021-9150(99)00142-2 Occurrence Handle1:CAS:528:DyaK1MXls12htbk%3D

    Article  CAS  Google Scholar 

  14. InstitutionalAuthorNameTASC Working Group (2000) ArticleTitleManagement of peripheral arterial disease Transatlantic Inter-Society Consensus Int Angiol 19 IssueIDSuppl 1 5–34

    Google Scholar 

  15. F Ando K Takekuma N Niino H Shimokata (2000) ArticleTitleUltrasonic evaluation of common carotid intima-media thickness (IMT): Influence of local plaque on the relationship between IMT and age J Epidemiol 10 IssueIDSuppl S10–17 Occurrence Handle1:STN:280:DC%2BD3c3psFGgsg%3D%3D Occurrence Handle10835823

    CAS  PubMed  Google Scholar 

  16. J Gariepy J Salomon N Denarie F Laskri JL Megnien J Levenson A Simon (1998) ArticleTitleSex and topographic differences in associations between large-artery wall thickness and coronary risk profile in a French working cohort: The AXA Study Arterioscl Thromb Vasc Biol 18 584–590 Occurrence Handle1:STN:280:DyaK1c3hsFWnug%3D%3D Occurrence Handle9555864

    CAS  PubMed  Google Scholar 

  17. IM Meer ParticleVan der A Iglesias Sol Particledel AE Hak ML Bots A Hofman JC Witteman (2003) ArticleTitleRisk factors for progression of atherosclerosis measured at multiple sites in the arterial tree: The Rotterdam study Stroke 34 2374–2379 Occurrence Handle10.1161/01.STR.0000088643.07108.19 Occurrence Handle12947155

    Article  PubMed  Google Scholar 

  18. E Eschwege (2003) ArticleTitleThe dysmetabolic syndrome, insulin resistance and increased cardiovascular (CV) morbidity and mortality in type 2 diabetes: Aetiological factors in the development of CV complications Diabetes Metab 294 Pt. 2 19–27

    Google Scholar 

  19. M Laakso H Sarlund R Salonen M Suhonen K Pyorala JT Salonen P Karhapaa (1991) ArticleTitleAsymptomatic atherosclerosis and insulin resistance Arterioscl Thromb 11 1068–1076 Occurrence Handle1:STN:280:By6B1M7nslE%3D Occurrence Handle2065028

    CAS  PubMed  Google Scholar 

  20. RW Stout (1982) ArticleTitleHyperinsulinaemia as an independent risk factor for atherosclerosis Int J Obes 6 IssueIDSuppl 1 111–115 Occurrence Handle6749715

    PubMed  Google Scholar 

  21. RW Stout (1981) ArticleTitleThe role of insulin in atherosclerosis in diabetics and nondiabetics: A review Diabetes 30 IssueIDSuppl 2 54–57 Occurrence Handle1:STN:280:Bi2D2M7ht1E%3D Occurrence Handle6795073

    CAS  PubMed  Google Scholar 

  22. AR Folsom JH Eckfeldt S Weitzman J Ma LE Chambless RW Barnes KB Cram RG Hutchinson (1994) ArticleTitleRelation of carotid artery wall thickness to diabetes mellitus, fasting glucose and insulin, body size, and physical activity Atherosclerosis Risk in Communities (ARIC) Study Investigators. Stroke 25 66–73 Occurrence Handle1:STN:280:ByuD1M%2FmvVY%3D

    CAS  Google Scholar 

  23. M Wohlin J Sundstrom J Arnlov B Andren B Zethelius L Lind (2003) ArticleTitleImpaired insulin sensitivity is an independent predictor of common carotid intima-media thickness in a population sample of elderly men Atherosclerosis 170 181–185 Occurrence Handle10.1016/S0021-9150(03)00283-1 Occurrence Handle1:CAS:528:DC%2BD3sXmvVyhsrk%3D Occurrence Handle12957698

    Article  CAS  PubMed  Google Scholar 

  24. A Hamsten U Faire Particlede G Walldius G Dahlen A Szamosi C Landou M Blomback B Wiman (1987) ArticleTitlePlasminogen activator inhibitor in plasma: Risk factor for recurrent myocardial infarction Lancet 2 3–9 Occurrence Handle10.1016/S0140-6736(87)93050-9 Occurrence Handle1:STN:280:BiiB2MnktlM%3D Occurrence Handle2885513

    Article  CAS  PubMed  Google Scholar 

  25. R Donnelly JM Yeung G Manning (2003) ArticleTitleMicroalbuminuria: A common, independent cardiovascular risk factor, especially but not exclusively in type 2 diabetes J Hypertens 21 IssueIDSuppl 1 S7–12 Occurrence Handle10.1097/00004872-200307000-00003 Occurrence Handle1:CAS:528:DC%2BD3sXksVKrur4%3D

    Article  CAS  Google Scholar 

  26. A Jager PJ Kostense HG Ruhe RJ Heine G Nijpels JM Dekker LM Bouter CD Stehouwer (1999) ArticleTitleMicroalbuminuria and peripheral arterial disease are independent predictors of cardiovascular and all-cause mortality, especially among hypertensive subjects: five-year follow-up of the Hoorn study Thromb Vasc Biol 19 617–624 Occurrence Handle1:STN:280:DyaK1M7nsVWisQ%3D%3D

    CAS  Google Scholar 

  27. L Mykkänen DJ Zaccaro DH O’Leary G Howard DC Robbins SM Haffner (1997) ArticleTitleMicroalbuminuria and carotid artery intima-media thickness in nondiabetic and NIDDM subjects The Insulin Resistance Atherosclerosis Study (IRAS). Stroke 28 1710–1716 Occurrence Handle9303013

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Bettina-Maria Taute M.D..

About this article

Cite this article

Taute, BM., Schoenmetzler, M., Taute, R. et al. Common Carotid Intima-media Thickness in Peripheral Arterial Disease. International Journal of Angiology 13, 27–30 (2004). https://doi.org/10.1007/s00547-004-1062-2

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00547-004-1062-2

Keywords

Navigation