Associations of extracranial carotid atherosclerosis progression with coronary status and risk factors in patients with and without coronary artery disease

• Published in: Circulation (New York, N.Y.) Vol. 106; no. 16; pp. 2061 - 2066
• Main Authors: CROUSE, John R, RONG TANG, ESPELAND, Mark A, TERRY, James G, MORGAN, Timothy, MERCURI, Michele
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 15.10.2002; American Heart Association, Inc
• Subjects: Atherosclerosis (general aspects, experimental research); Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Carotid Artery Diseases - diagnostic imaging; Carotid Artery Diseases - epidemiology; Carotid Artery Diseases - etiology; Coronary Angiography; Coronary Artery Disease - complications; Coronary Artery Disease - diagnostic imaging; Disease Progression; Female; Humans; Male; Medical sciences; Middle Aged; Risk Factors; Tunica Media - diagnostic imaging; Ultrasonography; Sonography; Human; Pathophysiology; Cardiovascular disease; Extracranial; Coronary heart disease; Vascular disease; Thickness; Concomitant disease; Carotid; Atherosclerosis; Risk factor; Evolution; Vascular wall; Comparative study
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/01.CIR.0000033833.54884.34

Intimal medial thickness of the extracranial carotid arteries (IMT) is related to coronary artery disease (CAD) and CAD risk factors. Few studies have explored the association of risk factors with progression of IMT, and none have evaluated their associations with IMT progression specifically in patients with and without CAD. We used coronary angiography to identify 280 patients equally divided between men and women and those with either > or =50% coronary artery stenosis or no CAD. Risk factors were measured at baseline and IMT was measured at baseline and yearly for 3 years in 241 of these individuals. Baseline risk factors and CAD status were related to IMT progression. IMT of patients with CAD progressed 3 times faster than that of patients with no CAD (mean+/-SEM, 33.7+/-7.4 versus 8.9+/-7.1 microm/year; P=0.02), and CAD status and high-density lipoprotein (HDL) cholesterol were independently associated with IMT progression. Male sex, increased waist to hip ratio, cigarette smoking, increased triglycerides, and decreased HDL cholesterol were associated with increased progression in CAD patients. Patients with CAD have more rapid progression of IMT than CAD-free controls, and risk factors are related to progression in them.