Association of increased carotid intima-media thickness with the extent of coronary artery disease

被引:209
作者
Kablak-Ziembicka, A
Tracz, W
Przewlocki, T
Pieniazek, P
Sokolowski, A
Konieczynska, M
机构
[1] Jagiellonian Univ, John Paul II Hosp, Coll Med, Dept Cardiac & Vasc Dis, PL-31202 Krakow, Poland
[2] Krakow Univ Econ, Krakow, Poland
关键词
D O I
10.1136/hrt.2003.025080
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: To investigate (a) the relation between intima-media thickness (IMT) in carotid arteries and the extent of coronary artery disease (CAD); and (b) whether IMT is predictive of coronary atherosclerosis. The coexistence of severe extracranial atherosclerosis in patients with CAD was also analysed. Methods: Coronary angiography and carotid ultrasound evaluation were performed in 558 consecutive patients (438 men), with a mean (SD) age of 58.8 (9.2) years and suspected CAD. Mean IMT was measured at both carotid arteries and expressed as the mean aggregate value. The relation between IMT and severity of CAD was determined. Results: A significant correlation between mean IMT and advancing CAD (p<0.0001) was found. Four independent predictors of CAD were found in the discriminant analysis: age (p=0.0193), hyperlipidaemia (p<0.0001), smoking (p=0.0032), and IMT (p<0.0001). A significant increase in IMT was observed among patients with one, two, and three vessel CAD. A log normal distribution of IMT values showed that if mean IMT was over 1.15 mm, patients had a 94% probability of having CAD, with sensitivity of 65% and specificity of 80% in the patients with a high risk of CAD. The number of critically stenosed extracranial arteries increased with advancing CAD. None of the patients with normal coronary arteries had severe stenosis of the extracranial arteries. Severe carotid, vertebral, or subclavian stenosis was found in 16.6% of patients with three vessel CAD. Conclusions: IMT increases with advancing CAD, patients with mean IMT over 1.15 mm have a 94% likelihood of having CAD, and the coexistence of CAD with severe stenosis of aortic arch arteries is relatively high and was found in 16.6% of patients with three vessel CAD.
引用
收藏
页码:1286 / 1290
页数:5
相关论文
共 34 条
[1]   CAROTID INTIMA-MEDIA THICKNESS IS ONLY WEAKLY CORRELATED WITH THE EXTENT AND SEVERITY OF CORONARY-ARTERY DISEASE [J].
ADAMS, MR ;
NAKAGOMI, A ;
KEECH, A ;
ROBINSON, J ;
MCCREDIE, R ;
BAILEY, BP ;
BENFREEDMAN, S ;
CELERMAJER, DS .
CIRCULATION, 1995, 92 (08) :2127-2134
[2]   Early results of percutaneous intervention for severe coexisting carotid and coronary artery disease [J].
Al-Mubarak, N ;
Roubin, GS ;
Liu, MW ;
Dean, LS ;
Gomez, CR ;
Iyer, SS ;
Vitek, JJ .
AMERICAN JOURNAL OF CARDIOLOGY, 1999, 84 (05) :600-+
[3]  
Babatasi G, 1996, ANN CARDIOL ANGEIOL, V45, P24
[4]  
BARNES RW, 1981, SURGERY, V90, P1075
[5]   Common carotid intima-media thickness and risk of stroke and myocardial infarction - The Rotterdam Study [J].
Bots, ML ;
Hoes, AW ;
Koudstaal, PJ ;
Hofman, A ;
Grobbee, DE .
CIRCULATION, 1997, 96 (05) :1432-1437
[6]   Rationale, design, and baseline characteristics of the Prospective Randomized Evaluation of the Vascular Effects of Norvasc Trial (PREVENT) [J].
Byington, RP ;
Miller, ME ;
Herrington, D ;
Riley, W ;
Pitt, B ;
Furberg, CD ;
Hunninghake, DB ;
Mancini, GBJ .
AMERICAN JOURNAL OF CARDIOLOGY, 1997, 80 (08) :1087-&
[7]   CAROTID ENDARTERECTOMY CAN BE SAFELY PERFORMED WITH ACCEPTABLE MORTALITY AND MORBIDITY IN PATIENTS REQUIRING CORONARY-ARTERY BYPASS GRAFTS [J].
CHANG, BB ;
DARLING, RC ;
SHAH, DM ;
PATY, PSK ;
LEATHER, RP .
AMERICAN JOURNAL OF SURGERY, 1994, 168 (02) :94-96
[8]   EVALUATION OF THE ASSOCIATIONS BETWEEN CAROTID-ARTERY ATHEROSCLEROSIS AND CORONARY-ARTERY STENOSIS - A CASE-CONTROL STUDY [J].
CRAVEN, TE ;
RYU, JE ;
ESPELAND, MA ;
KAHL, FR ;
MCKINNEY, WM ;
TOOLE, JF ;
MCMAHAN, MR ;
THOMPSON, CJ ;
HEISS, G ;
CROUSE, JR .
CIRCULATION, 1990, 82 (04) :1230-1242
[9]   ASSOCIATION OF CORONARY-DISEASE WITH SEGMENT-SPECIFIC INTIMAL-MEDIAL THICKENING OF THE EXTRACRANIAL CAROTID-ARTERY [J].
CROUSE, JR ;
CRAVEN, TE ;
HAGAMAN, AP ;
BOND, MG .
CIRCULATION, 1995, 92 (05) :1141-1147
[10]   PRAVASTATIN, LIPIDS, AND ATHEROSCLEROSIS IN THE CAROTID ARTERIES (PLAC-II) [J].
CROUSE, JR ;
BYINGTON, RP ;
BOND, MG ;
ESPELAND, MA ;
CRAVEN, TE ;
SPRINKLE, JW ;
MCGOVERN, ME ;
FURBERG, CD .
AMERICAN JOURNAL OF CARDIOLOGY, 1995, 75 (07) :455-459