Femoral Intima-media Thickness, Risk Factors, and Markers of Inflammation in Cardiovascular Disease

Abstract

Introduction:The burden of coronary artery disease (CAD) and peripheral vascular pathologies caused by atherosclerosis is constantly increasing. There is continuous research aiming to develop new methods that can evaluate the extent of atherosclerotic disease in different vascular beds, thus estimating global risk. Similar to carotid artery thickness, which is an established marker for increased cardiovascular risk and cerebrovascular disease, femoral intima-media thickness (f-IMT) may have the same role in case of peripheral arterial involvement. The aim of the study was determine whether f-IMT, determined at the level of the superficial femoral artery, is related to traditional risk factors, markers of peripheral vascular atherosclerosis and inflammation. Material and methods: Forty-six patients with known cardiovascular disease were included in the study. Demographical data, cardiovascular history, and risk factors were assessed. We determined metabolic parameters (uric acid, fasting glucose, total cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides), renal function (creatinine and GFR), and inflammation status for all patients. Each patient underwent ultrasound examination of the superficial femoral artery, by which f-IMT was determined for right and left limbs. Ankle-brachial index was also calculated. Data from the low (f-IMT <0.75 mm) and high (f-IMT >0.75 mm) f-IMT groups were compared and correlation coefficients were determined in each groups for f-IMT in relation to the other parameters. Results: Mean age was 71.08 ± 9.78 years. 86.95% of the patients suffered from hypertension, 56.62% had coronary heart disease, and 21.73% had a history of stroke. More females had history of hypertension and CAD. The most prevalent cardiovascular risk factors were dyslipidemia (68.86%), diabetes (21.73%), and smoking (21.73%). There were significant differences between gender groups for total cholesterol levels (161.36 ± 25.04 mg/dL, in females, p = 0.02), creatinine values (1.04 ± 0.22 mg/dL, 95%CI 0.94-1.14 for males vs. 0.91 ± 0.23 mg/dL, 95%CI 0.81-1.00 for females, p = 0.018), and left f-IMT (0.87 ± 0.18 mm, 95%CI 0.79-0.95 for males vs. 0.75 ± 0.10 mm, 95%CI 0.70-0.79 for females, p = 0.0049). In the group with low f-IMT, a significant, reverse correlation was established between f-IMT, uric acid (r = -0.483, p = 0.042), and right ABI (r = -730, p = 0.0006). In the group with high f-IMT, age (r = 0.408, p = 0.031), fasting glucose (r = 0.407, p = 0.034), total cholesterol (r = 0.429, p = 0.02), HDL-cholesterol (r = -0.56, p = 0.0019), triglycerides (r = 0.45, p = 0.01), hs-CRP (r = 0.45, p = 0.01), and left ABI (r = -0.71, p <0.0001) showed a significant correlation to f-IMT. Conclusions: Increased femoral intima-media thickness is related to age, cardiovascular risk factors, and markers of peripheral arterial disease. Patients with higher f-IMT have a more augmented inflammatory status. Based on these correlations, in patients with cardiovascular disease, f-IMT could become a marker for increased cardi...

<p>The Association Between Femoral Artery Intima-Media Thickness and Serum Glucagon-Like Peptide-1 Levels Among Newly Diagnosed Patients with Type 2 Diabetes Mellitus</p>

“…4 Common femoral arteries lay shallowly to the superficial surface and appear to be easy to evaluate morphology and size, recently, studies started focusing on the potential role of intima-media thickness measured at the femoral artery in assessing cardiovascular risk and increased IMT at the femoral arteries in a population suffering from hypertensive and diabetes patients. [5][6][7] Intima-media thickness under 2D ultrasound findings is one of the useful surrogate endpoints for arterial diseases and a feasible method in routine clinical practice. 8,9 Doppler ultrasonography is a practical method to discover and measure arterial media as well as sizes of atherosclerosis plaques, blood flow velocity, which results in a good screening apparatus to evaluate and to prognosis arterial thrombosis and occlusion with high accuracy.…”

Korelasi Ketebalan Tunika Intima Media Arteri Femoralis Dan Arteri Karotis Berdasarkan Ultrasonografi Dengan Derajat Stenosis Arteri Koroner Berdasarkan MSCT Scan Kardiak Pada Pasien Penyakit Jantung Koroner

“…Yang mana semakin tebal IMT arteri femoralis semakin berat stenosis arteri koronaria. Hal ini sesuai dengan literatur bahwa ketebalan tunika intima-media merupakan penanda risiko aterosklerosis arteri koronaria 6,7,14 juga membuktikan bahwa keadaan dinding arteri femoralis mencerminkan keadaan dinding arteri koroner, sehingga penebalan FIMT dapat dipakai sebagai penanda terdapatnya aterosklerosis pada pembuluh darah jantung. Penelitian sebelumnya mengatakan aerosklerosis berkembang lebih lambat di SFA dibandingkan dengan arteri koroner dan karotis.…”

Lower Plasma Albumin, Higher White Blood Cell Count and High-Sensitivity C-Reactive Protein are Associated with Femoral Artery Intima-Media Thickness Among Newly Diagnosed Patients with Type 2 Diabetes Mellitus

“… 10–12 It is indisputable that cardiovascular risk factors (for example, age, duration of type 2 diabetes, smoking, hypertension, hyperglycemia, dyslipidemia, overweight, and obesity) in diabetic patients promote endothelium dysfunction and atherosclerosis of femoral arteries. 7 , 11 Diabetes enhances the risk of inflammation via increases in hs-CRP, interleukin (such as interleukin-4,6,8,17), tumor necrosis factor-alpha, platelet adhesion and aggregation, and coagulation disorders, which contributes to developing endothelium dysfunction. 7 , 13 , 14 Recent studies have demonstrated hypoalbuminemia and an increase in inflammatory factors such as hs-CRP and white blood cell count are the main factors for endothelium dysfunction and atherosclerosis in diabetic patients.…”