P759Clinical significance of separate measurements of Carotid intima and media thickness for assessing coronary atherosclerosis.


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Abstract

Objective: The clinical significance of separate measurement of Carotid intima-media thickness (CIMT), which is the sum of the intima (IT) and media thickness (MT), for its role in coronary artery disease (CAD) has not yet been fully established.Methods: Among 3377 patients who underwent B-mode ultrasound of carotid arteries in the Medical Department of St. Mary's Hospital from September 2003 to March 2009, 3125 subjects (M:F = 1862:1263; median age, 62 years) who underwent coronary angiography were enrolled in this study. CAD was defined as coronary artery stenosis of more than 50% of the vessel diameter. IT, MT and CIMT were measured separately from the enrolled patients using a 15 MHz linear array transducer.Results: In multivariate logistic analysis, age, HbA1c and systolic blood pressure are associated with CIMT and MT. Age, body mass index, HDL-C and ejection fraction are associated with IT. To reduce the effect of potential confounding and selection bias, we performed rigorous adjustments for differences in baseline characteristics of patients by use of inverse probability-of exposure weights (IPW). After using IPW, CIMT on both sides and MT on the right side in CAD patients were thicker than those in control groups.Conclusions: Separate measurements of CIMT, MT and IT are useful methods for assessing the effect of atherosclerotic risk factors on the arterial wall. Moreover, the MT, as well as the CIMT, is independent risk factor of CAD.

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