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Intima–media Thickness Score from Carotid and Femoral Arteries Predicts the Extent of Coronary Artery Disease

Intima–media thickness and CAD

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Abstract

Objectives: In the present study we measured carotid and femoral intima–media thickness (IMT) by B-Mode ultrasonography, as well as angiographic extent and severity of coronary artery disease in patients referred for coronary arteriography, to assess the relation between individual IMT, scores incorporating IMT from the carotid and femoral arteries and the extent and severity of coronary artery disease. Methods: Two hundred and two patients referred for elective coronary angiography underwent ultrasound imaging of both carotid and femoral arteries for IMT measurements. An IMT score was developed as the number of sites with abnormal IMT (range 0–8). Multiple regression analysis indicated that IMT score was independently related to Gensini score, age and glucose levels. A high risk IMT score predicted an extended coronary artery disease although a low or medium risk IMT score cannot exclude the possibility of multivessel disease. Also, a high risk group could predict the performance of revascularization procedures and all cardiovascular events during a follow-up of 14.5 ± 2.4 months.Conclusions: IMT incorporating data from common and internal carotid artery, carotid bifurcation and femoral artery are well correlated with the extent of coronary atherosclerosis, much better than individual IMT. Patients with high IMT score usually have multivessel coronary artery disease and are at increased risk for subsequent cardiovascular events.

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References

  1. MR Adams A Nakagomi A Keech et al. (1995) ArticleTitleCarotid intima-media thickness is only weakly correlated with the extent and severity of coronary artery disease Circulation 92 2127–2134 Occurrence Handle7554192

    PubMed  Google Scholar 

  2. TE Craven JE Ryn MA Espeland et al. (1990) ArticleTitleEvaluation of the association between carotid artery atherosclerosis and coronary artery stenosis Circulation 82 1230–1242 Occurrence Handle2205416

    PubMed  Google Scholar 

  3. G Howard AR Sharrett G Heiss et al. (1993) ArticleTitleCarotid artery intimal–medial thickness distribution in general populations as evaluated by B-mode ultrasound Stroke 24 1297–1304 Occurrence Handle8362421

    PubMed  Google Scholar 

  4. A Kitamura H Iso H Imano et al. (2004) ArticleTitlePrevalence and correlates of carotid atherosclerosis among elderly Japanese men Atherosclerosis 172 353–359 Occurrence Handle10.1016/j.atherosclerosis.2003.10.012 Occurrence Handle15019546

    Article  PubMed  Google Scholar 

  5. ML Bots AW Hoes PS Koudstall A Hofman DE. Grobbee (1997) ArticleTitleCommon carotid intima–media thickness and risk of stroke and myocardial infarction The Rotterdam study. Circulation 96 1432–1437

    Google Scholar 

  6. DH O’Leary JF Polak RA Kronmal et al. (1999) ArticleTitleCarotid artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults N Engl J Med 340 14–22 Occurrence Handle10.1056/NEJM199901073400103 Occurrence Handle9878640

    Article  PubMed  Google Scholar 

  7. E De Groot JW Jukema AD Montauban et al. (1998) ArticleTitleB-mode ultrasound assessment of pravastatin treatment effect on carotid and femoral artery walls and its correlations with coronary arteriographic findings. A report of the regression growth evaluation statin study (REGRESS) J Am Coll Cardiol 31 1561–1567 Occurrence Handle9626835

    PubMed  Google Scholar 

  8. JL Megnien A Simon J Gaziepy et al. (1986) ArticleTitlePreclinical changes of extracoronary arterial structure as indicators of coronary atherosclerosis extent by B-mode ultrasound Stroke 17 270–275 Occurrence Handle3083535

    PubMed  Google Scholar 

  9. JR Crouse GH Harpold FR Kahl JF Toole WM. McKinney (1980) ArticleTitleEvaluation of a scoring system for extracranial carotid atherosclerosis extent by B-mode ultrasound Stroke 17 270–275

    Google Scholar 

  10. N Handa M Matsumoto H Maeda et al. (1990) ArticleTitleUltrasonic evaluation of early carotid atherosclerosis Stroke 21 1567–1572 Occurrence Handle2237950

    PubMed  Google Scholar 

  11. DM Herrington JA Bean M. Mercuri (1994) ArticleTitleStrong correlation between carotid artery wall thickness and quantitative coronary angiographic assessment of coronary atherosclerosis [abstract] Circulation 90 IssueIDSuppl. I 534

    Google Scholar 

  12. GG. Gensini (1975) Coronary Angiography Futura Publishing Co Mount Kisco, NY

    Google Scholar 

  13. DH O’Leary JF. Polak (2002) ArticleTitleIntima–media thickness: a tool for atherosclerosis imaging and event prediction Am J Cardiol 90 IssueID10C 18L–21L Occurrence Handle10.1016/S0002-9149(02)02957-0 Occurrence Handle12459422

    Article  PubMed  Google Scholar 

  14. KS Cheng DP Mikhailidis G Hamilton AM. Seifalian (2002) ArticleTitleA review of the carotid and femoral intima-media thickness as an indicator of the presence of peripheral vascular disease and cardiovascular risk factors Cardiovasc Res 54 528–538 Occurrence Handle10.1016/S0008-6363(01)00551-X Occurrence Handle12031698

    Article  PubMed  Google Scholar 

  15. JR Crouse TE Craven Ap Hagaman G. Bond (1995) ArticleTitleAssociation of coronary disease with segment-specific intimal–medial thickening of the extracranial carotid artery Circulation 92 1141–1147 Occurrence Handle7648658

    PubMed  Google Scholar 

  16. J Hulthe J Wikstrand H Emanuelson O Wiklund PJ Feyter Particlede I. Wendelhag (1997) ArticleTitleAtherosclerotic changes in the carotid artery bulb as measured by B-mode ultrasound are associated with the extent of coronary atherosclerosis Stroke 28 1189–1194 Occurrence Handle9183349

    PubMed  Google Scholar 

  17. JP Lekakis CM Papamichael AT Cimponeriu et al. (2000) ArticleTitleAtherosclerotic changes of extracoronary arteries are associated with the extent of coronary atherosclerosis Am J Cardiol 85 949–952 Occurrence Handle10.1016/S0002-9149(99)00907-8 Occurrence Handle10760332

    Article  PubMed  Google Scholar 

  18. O. Smedby (1998) ArticleTitleGeometrical risk factors for atherosclerosis in the femoral artery: a longitudinal angiographic study Ann Biomed Eng 26 391–397 Occurrence Handle10.1114/1.121 Occurrence Handle9570222

    Article  PubMed  Google Scholar 

  19. O Smedby S Nilsson L. Bergstrand (1996) ArticleTitleDevelopment of femoral atherosclerosis in relation to flow disturbance J Biomech 29 543–547 Occurrence Handle10.1016/0021-9290(95)00070-4 Occurrence Handle8964784

    Article  PubMed  Google Scholar 

  20. KC Sutton SK Wolfson LH. Kuller (1987) ArticleTitleCarotid and lower extremity arterial disease in elderly adults with isolated systolic hypertension Stroke 18 817–822 Occurrence Handle3307033

    PubMed  Google Scholar 

  21. A Poli E Tremoli A Colombo M Sirtori P Dignoli R. Paoletti (1988) ArticleTitleUltrasonographic measurement of the common carotid artery wall thickness in hypercholesterolemic patients Atherosclerosis 70 253–261 Occurrence Handle10.1016/0021-9150(88)90176-1 Occurrence Handle3284536

    Article  PubMed  Google Scholar 

  22. R Salonen JT. Salonen (1990) ArticleTitleProgression of carotid atherosclerosis and its determinants: A population-based ultrasonography study Atherosclerosis 81 33–40 Occurrence Handle10.1016/0021-9150(90)90056-O Occurrence Handle2407252

    Article  PubMed  Google Scholar 

  23. J Bogonsslavsky GV Melle PA Despland F. Regli (1990) ArticleTitleAlcohol consumption and carotid atherosclerosis in the Lausanne stroke registry Stroke 21 715–720 Occurrence Handle2187288

    PubMed  Google Scholar 

  24. G Heiss AR Sharrett R Barnes et al. (1991) ArticleTitleCarotid atherosclerosis measured by B-mode ultrasound in population Association with cardiovascular risk factors in the ARIC study. Am J Epidemiol 134 250–256

    Google Scholar 

  25. ML Hijmering ML Bots ESG Stroes P Morrison TJ. Rabelink (1999) ArticleTitleNon-invasive evaluation of vascular function Eur Heart J 1 IssueIDSuppl M M18–M26

    Google Scholar 

  26. PH Davis JD Dawson LT Mahoney RM. Laner (1999) ArticleTitleIncreased carotid intimal–medial thickness and coronary calcification are related in young and middle-aged adults The Muscatine Study. Circulation 100 838–842

    Google Scholar 

  27. J Gariepy J Salomon N Denarie et al. (1998) ArticleTitleSex and topographic differences in association between large-artery wall thickness and coronary risk profile in a French working cohort: the AXA study Arterioscler Thromb Vasc Biol 18 584–590 Occurrence Handle9555864

    PubMed  Google Scholar 

  28. PI Mowbray AJ Lee GR Fowkes PL. Allan (1997) ArticleTitleCardiovascular risk factors for early atherosclerosis in the general population: The Edinburgh Artery Study J Cardiovasc Risk 4 357–362 Occurrence Handle9865667

    PubMed  Google Scholar 

  29. C Bonithon-Kopp P Scarabin A Taquet P Touboul A Malnejak L. Guize (1991) ArticleTitleRisk factors for early carotid atherosclerosis in middle-aged French women Arterioscler Thromb 11 966–972 Occurrence Handle2065047

    PubMed  Google Scholar 

  30. K Sutton-Tyrrell HC Lassila E Meilahn C Bunker KA Matthews LH. Kuller (1998) ArticleTitleCarotid atherosclerosis in postmenopausal women and its association with risk factors measured after menopause Stroke 29 1116–1121 Occurrence Handle9626281

    PubMed  Google Scholar 

  31. LE Chambless G Heiss AR Folson et al. (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 Handle9290509

    PubMed  Google Scholar 

  32. RL Bard H Kalsi M Rubenfire et al. (2004) ArticleTitleEffect of carotid atherosclerosis screening on risk stratification during primary cardiovascular disease prevention Am J Cardiol 93 1030–1032 Occurrence Handle10.1016/j.amjcard.2003.12.056 Occurrence Handle15081449

    Article  PubMed  Google Scholar 

  33. HN Hodis WJ Mack L LaBree et al. (1998) ArticleTitleThe role of carotid artery intima–media thickness in predicting clinical coronary events Ann Intern Med 128 262–269 Occurrence Handle9471928

    PubMed  Google Scholar 

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Lekakis, J.P., Papamichael, C., Papaioannou, T.G. et al. Intima–media Thickness Score from Carotid and Femoral Arteries Predicts the Extent of Coronary Artery Disease. Int J Cardiovasc Imaging 21, 495–501 (2005). https://doi.org/10.1007/s10554-004-8165-x

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  • DOI: https://doi.org/10.1007/s10554-004-8165-x

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