The Prognostic Significance of Carotid Intima-Media Thickness in Patients Who Underwent Percutaneous Coronary Intervention

Abstract

Background and Objectives：Increased carotid intima-media thickness (IMT) is known to be associated with adverse cardiovascular events in the patients with risk factors or established atherosclerosis. However, the prognostic importance of carotid IMT is uncertain in the patients who underwent percutaneous coronary intervention (PCI). We sought to evaluate the association of carotid IMT with major adverse cardiovascular events (MACE) and restenosis in the patients who underwent PCI. Subjects and Methods：The study population consisted of 308 consecutive patients who underwent PCI, and they were followed up for mean of 30.6±13.3 months. Base on the median values of carotid IMT, which was measured in the right common carotid artery at the time of PCI with using high-resolution ultrasound and a semiautomatic method, the subjects were divided into the thick (n=156, 1.003±0.14 mm) and thin IMT (n=152, 0.748±0.07 mm) groups, and they were followed up for at least 1 year. Results：Patients with thick carotid IMT were older (61±9 years vs. 57±10 years, respectively, p=0.001), had a higher body mass index (25.0±3.0 vs. 23.9±4.0, respectively, p=0.017), a history of previous myocardial infarction (20% vs. 9%, respectively, p=0.008), more multivessel disease and more restenosis (34.6% vs. 23.0%, respectively, p=0.025) than those patients with a thin carotid IMT. However other MACEs such as death, myocardial infarction, stroke, heart failure and target lesion revascularization did not show any significant differences between the two groups. Multivariate Cox regression analysis showed that carotid IMT was an independent predictor of restenosis (odds ratio: 1.754, 95% confidence interval: 1.1296 to 2.726, p=0.012). Conclusion：An increased carotid IMT is associated with restenosis, but it does not have clinical prognostic importance for the patients who underwent PCI during a mean follow up period of 31 months. (Korean Circulation J 2007;37:103-107)

Epaisseur de l’intima-média carotidienne et facteurs de risque cardio-vasculaires

“…Par défaut de méthode automatique qui offre plus de facilité et de précision [ 6 ], nous avons réalisé une mesure manuelle de l'EIM de la carotide commune. Malgré cette limite, ce travail a permis d’étudier les sujets à risque cardio-vasculaire dans la mesure où l'augmentation de l'EIM de la carotide est reconnue comme étant associée à un risque plus élevé de survenue d’événements cardio-vasculaires chez les patients présentant des FDR d'athérosclérose [ 7 ].…”

National Analysis of Coronary Artery Bypass Grafting in Autoimmune Connective Tissue Disease

“…This might be particularly valid because patients with CTDs also exhibit endothelial dysfunction 19 and medial wall thickening, both risk factors for failure of intravascular stents. 20,21 In the present study there was a nearly 50% increase in the proportion of CABG patient with CTDs over the past decade. Improved detection and coding of CTDs may further contribute to the rise of this diagnosis among patients undergoing CABG.…”

Evaluation of relationship between common carotid artery intima-media thickness and coronary in-stent restenosis: A case-control study

“…However, on contrary to the findings of Kwon et al. [ 19 ], Lacroix et al. [ 37 ] performed univariate analysis and demonstrated that CIMT >0.7 mm was allied with an increased risk of cardiac events after coronary angioplasty compared with those with CIMT <0.7 mm ( p =0.03).…”

“…[ 24 ] and Kwon et al. [ 19 ], whereas on the other hand, Macdonald et al. [ 26 ] showed that age and sex had no association with restenosis.…”

“…Kwon et al. [ 19 ] had distributed patients with ISR into two groups: thin CIMT (<0.84 mm) and thick CIMT (>0.84 mm) and estimated clinical events at 12 months post-PCI. They observed that major adverse cardiovascular events were not different between the thick CIMT and thin CIMT groups, except for restenosis (OR = 1.754, CI: 1.129–2.726, p = 0.012).…”