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- Title
The role of carotid arterial intima-media thickness in predicting clinical coronary events.
- Authors
Hodis, H N; Mack, W J; LaBree, L; Selzer, R H; Liu, C R; Liu, C H; Azen, S P
- Abstract
<bold>Background: </bold>Carotid arterial intima-media thickness is used as a noninvasive surrogate end point to measure progression of atherosclerosis, but its relation to coronary events has not been fully explored.<bold>Objective: </bold>To determine whether carotid arterial intima-media thickness predicts coronary events.<bold>Design: </bold>Long-term follow-up (average, 8.8 years) of a previously assembled cohort of persons who completed the 2-year Cholesterol Lowering Atherosclerosis Study, a randomized arterial imaging trial designed to study the effects of lipid lowering on progression of atherosclerosis.<bold>Setting: </bold>University-based ultrasonography laboratory.<bold>Patients: </bold>146 men 40 to 59 years of age who had previously had coronary artery bypass graft surgery.<bold>Measurements: </bold>Preintrusive atherosclerosis in the common carotid artery was evaluated every 6 months with B-mode ultrasonography, and intrusive atherosclerosis in the coronary arteries was evaluated at baseline and at 2 years with quantitative coronary angiography. After the trial, the incidences of coronary events (nonfatal acute myocardial infarction, coronary death, and coronary artery revascularization) were documented.<bold>Results: </bold>For each 0.03-mm increase per year in carotid arterial intima-media thickness, the relative risk for nonfatal myocardial infarction or coronary death was 2.2 (95% CI, 1.4 to 3.6) and the relative risk for any coronary event was 3.1 (CI, 2.1 to 4.5) (P < 0.001). Absolute intima-media thickness was also related to risk for clinical coronary events (P < 0.02). Absolute thickness and progression in thickness predicted risk for coronary events beyond that predicted by coronary arterial measures of atherosclerosis and lipid measurements (P < 0.001).<bold>Conclusion: </bold>Noninvasive B-mode ultrasonographic measurement of progression of intima-media thickness in the distal common carotid artery is a useful surrogate end point for clinical coronary events.
- Publication
Annals of Internal Medicine, 1998, Vol 128, Issue 4, p262
- ISSN
0003-4819
- Publication type
journal article
- DOI
10.7326/0003-4819-128-4-199802150-00002