The value of lipoprotein (a), homocysteine, and Doppler of carotid and femoral arteries in assessment of atherosclerosis in asymptomatic cardiovascular risk patients

Objectives: To evaluate the role of non-traditional biochemical markers, and carotid and femoral Doppler in early detection of atherosclerosis in asymptomatic cardiovascular risk patients. Subjects and methods: This study was conducted on 72 patients with various cardiovascular risk factors (22 diabetic, 15 hypertensive, 20 smokers, and 15 obese), in addition to 18 healthy controls. All of them were subjected to complete examination, anthropometric measurements, calculation of Framingham risk score (FS) and measurement of lipoprotein (a) (Lp(a)), homocysteine, insulin, C-reactive protein (CRP) and microalbumin in urine (UAER) and calculation of insulin sensitivity. Intima-media thickness (IMT) and plaque formation were assessed in both carotid and femoral arteries. Results: Mean values of serum insulin, homocysteine, CRP, UAER, and the IMT of right and left common carotid, and right femoral arteries revealed significant elevation in all studied groups compared to controls and insulin sensitivity showed significant reduction. In group C (FS >= 20%) the mean values of triglycerides, Lp(a), and IMT of right femoral, right carotid, and left carotid arteries showed significant elevation compared to group A (FS < 10%) (p < 0.01). Age, waist circumference, waist/hip ratio, homocysteine, triglycerides, and CRP were predictors of IMT of carotid artery, while age, CRP, and triglycerides were predictors of atheroma. Conclusion: Non-traditional biochemical markers were elevated in all studied cardiovascular risk groups. IMT of carotid artery correlated with traditional risk factors and FS, as well as non-traditional risk factors. Carotid IMT measurement is recommended in both primary and secondary coronary heart disease prevention. (C) 2008 Japanese College of Cardiology. Published by Elsevier Ireland Ltd. All rights reserved.