Carotid Intima-Media Thickness, Systemic Inflammation, and Incidence of Heart Failure Hospitalizations

Abstract

Objectives-This study explored the relationships between carotid intima-media thickness (IMT), plasma levels of C-reactive protein (CRP), and incidence of heart failure hospitalizations. Methods and Results-Men and women from the general population (nϭ4691), without history of myocardial infarction or stroke, were examined. Incidence of hospitalizations attributable to heart failure was studied over a mean follow-up of 13 years. A total of 75 subjects were hospitalized with a primary diagnosis of heart failure. Adjusted for risk factors, the hazards ratios (95% CI) were 1.00, 0.98 (0.36 to 2.7), 1.9 (0.80 to 4.6), and 2.7 (1.1 to 6.2), respectively, for the 1st, 2nd, 3rd, and 4th quartiles of IMT (P for trendϭ0.003). The HR associated with CRP levels Ն3 mg/L (versus Ͻ1 mg/L) was 2.0 (95% CI: 1.06 to 3.9) after adjustments for risk factors. There was a significant interaction between IMT and CRP on heart failure incidence (Pϭ0.028). Subjects with CRP Ն3 mg/L and IMT in the 4th quartile had an adjusted HR of 3.7 (1.9 to 7.1) compared to those with CRP Ͻ3 mg/L and IMT in quartile 1 to 3. Conclusion-High IMT and high CRP are both independent risk factors for incidence of heart failure requiring hospitalization.The joint exposure to both risk factors substantially increases the risk.

Relation between intima-media thickness and bone mineral density in postmenopausal women: a cross-sectional study

“…8,9,[21][22][23] These two lines represent the lumen-intima and media-adventitia interfaces. There is currently a slight disagreement regarding the location at which the measurements should be taken, but recommendations for carotid ultrasound scanning protocols 14,15 were published recently in order to improve the power of clinical studies.…”

Hipertensión arterial: el factor de riesgo más importante para grosor íntima media carotídeo elevado y placa carotídea en adultos de Santiago

“…Los resultados aquí presentados, en población adulta de Santiago, dejan claro que este biomarcador podría ser útil en la mejor caracterización del riesgo de eventos CV en hipertensos. En este sentido, un artículo reciente, que relaciona positivamente el CIMT elevado y la presencia de PCRus elevada (es decir de infl amación subclínica) con la incidencia de hospitalizaciones por insufi ciencia cardiaca propone que, a diferencia de un factor como la presión arterial, que puede variar mucho en un mismo individuo, el "CIMT refl eja la exposición del mismo sujeto, durante un período más largo de tiempo, al factor de riesgo", lo que le daría al CIMT un alto y sólido valor pronóstico 25,26 .…”

Personalized Medicine in Cardiology: State, Problems and Prospects

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