Carotid intima-media thickness in pre-and postmenopausal women with suspected coronary artery disease

Abstract

Carotid intima-media thickness (CIMT) is an early marker of coronary artery disease (CAD). This study aimed to evaluate CIMT value for CAD prediction in pre-and postmenopausal women referred for coronary angiography with angina-like symptoms and a positive result of the treadmill test. The study comprised 321 women referred for coronary angiography with symptoms suggesting CAD. Carotid intima-media thickness was measured in common, bifurcation, and internal carotid artery, and expressed as the mean maximum value. Coronary angiography showed coronary stenosis > or = 50% in 211 (65.7%) women, including 27 with regular menses (47.3 +/- 3.4 years) and 184 postmenopausal (65.8 +/- 7.2 years). Normal coronary arteries were found in 110 women: 17 (47.3 +/- 4.9 years) with regular menses and 93 postmenopausal (64.3 +/- 6.5 years). The highest CIMT values were found in postmenopausal CAD women (1.360 +/- 0.32 mm), as compared to premenopausal with CAD (1.178 +/- 0.36 mm, P = 0.005), pre- (0.860 +/- 0.23 mm, P < 0.001) and postmenopausal (1.022 +/- 0.30 mm, P < 0.001) women without CAD. Carotid intima-media thickness (P < 0.001), hyperlipidemia (P = 0.018), and myocardial infarction (P < 0.001), but not menopause itself or the number of years since menses cessation, were found to be independent CAD predictors. By receiver operating characteristic calculation, the mean maximum CIMT cut-off values discriminating CAD were lower in premenopausal (> or = 0.933 mm) than in postmenopausal women (> or = 1.075 mm; P < 0.05) resulting in similar sensitivity (85.2% and 82.6%) and specificity (70.6% and 69.9%). Carotid intima-media thickness is a strong CAD predictor in both pre- and postmenopausal women, in contrast to the menopausal status.

Oxidized low-density lipoprotein in postmenopausal women

“…The atherosclerotic risk of postmenopausal women is 3.4 times higher compared with premenopausal women [17], and IMT has been shown to be a valid predictor of cardiovascular events in these patients [18]. Surprisingly, the median IMT of our sample was within the normal range for women of equal age [19].…”

Consider Preeclampsia as a First Cardiovascular Event

“…A widely used non-invasive measure to evaluate subclinical atherosclerosis is carotid intima-media thickness (cIMT) [44]. An increased cIMT value is a predictor of coronary artery disease in both pre-and postmenopausal women [45]. Two recent meta-analyses showed that cIMT values are higher in women after preeclampsia compared with those in women experiencing a normotensive pregnancy, both at time of pregnancy and in the first 10 years postpartum [46,47].…”

Effect of Menopausal Status on Carotid Intima-Media Thickness and Presence of Carotid Plaque in Chinese Women Generation Population

“…The gradual damage induces atherosclerosis, reduces the diameter of blood vessels, and then causes vascular stenosis 13 . Kablak and his colleagues reported that carotid intima-media thickness (CIMT) is a strong CAD predictor in both pre- and postmenopausal women, in contrast to that in the menopausal women 14 . While the association of menopause with CIMT and stroke has been suggested in the studies mentioned above, it is still unclear whether different menopause stages can affect CIMT differentially, thereby leading to potential differences in development and stability of carotid plaques in Chinese women population.…”