Carotid intima-media thickness as predictor of secondary events after coronary angioplasty
P Lacroix1, V Aboyans, E Espaliat
1Department of Cardiovascular Surgery, CHU Dupuytren, Limoges, France. lacroix@unilim.fr
Insights
Common carotid intima-media thickness (IMT) predicts cardiovascular events after percutaneous coronary angioplasty (PTCA). Measuring subclinical disease like IMT can identify high-risk patients for better management.
Area of Science:
- Cardiology
- Vascular Biology
- Diagnostic Imaging
Background:
- Peripheral arterial and cerebrovascular disease increase cardiovascular event risk.
- Percutaneous coronary angioplasty (PTCA) is a common intervention for coronary artery disease.
Purpose of the Study:
- To investigate if common carotid artery intima-media thickness (IMT) and/or ankle-brachial index (ABI) predict cardiovascular events post-PTCA.
- To assess the relationship between subclinical atherosclerosis markers and adverse outcomes after PTCA.
Main Methods:
- 113 patients undergoing PTCA were assessed for common carotid IMT and ABI within 2 days post-procedure.
- A composite endpoint including death, myocardial infarction, and angina recurrence was tracked over a mean follow-up of 10.2 months.
Main Results:
- Common carotid IMT >0.7 mm was a significant univariate predictor of cardiovascular events (p=0.03).
- Unstable angina and undergoing PTCA on the left descending coronary artery were also significant risk factors.
- No association was found between ABI and cardiovascular events post-PTCA.
Conclusions:
- Common carotid artery intima-media thickness (IMT) is associated with an increased risk of cardiac events following PTCA.
- Measuring subclinical disease, such as IMT, may aid in identifying high-risk patients after PTCA.
Aim:
Subjects with symptomatic or asymptomatic peripheral arterial or cerebro-vascular disease have an increased risk of death or cardiovascular event. The aim of this study was to determine whether intima-media thickening of the common carotid artery and/or a low ankle brachial index (ABI) are related with an increased risk of cardio-vascular event after percutaneous coronary angioplasty (PTCA).
Methods:
One hundred and thirteen consecutive, patients (88 males, 25 females, mean age: 62 years) undergoing PTCA were included. Intima media thickness (IMT) of the common carotid artery and ABI were measured within the 2 days following the PTCA. Subjects were followed up for 10.2 +/- 4 months. The end-point was a composite criterion associating death, non fatal acute myocardial infarction, recurrence or worsening of angina pectoris, hospitalisation for heart failure, new positive exercise stress testing.
Results:
In the follow-up study a common carotid IMT >0.7 mm was a predictor of event (p=0.03) in the univariate analysis. The other risk factors were unstable angina (p=0.001) and PTCA on the left descending coronary artery (p<0.05). We did not find any relation between the end-point and ABI or presence of atheroma on the common femoral artery. In the logistic regression analysis unstable angina was associated with a 3.14 fold increased risk (IC 95%: 1.51-6.4, p=0.002), subjects without HMG-CoA inhibitors drugs at the inclusion had also an increased risk of 2.5 (IC 95%:1.09-5.75, p=0.02).
Conclusion:
This study suggest that CCA-IMT is associated with an increased risk of cardiac events after PTCA. The measurement of subclinical disease could be useful for identifying high-risk patients.
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