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Tissue characterization identifies subjects with high risk of cardiovascular diseases
Naoto Katakami1, Yoshimitsu Yamasaki, Keisuke Kosugi
1Department of Internal Medicine and Therapeutics, Osaka University Graduate School of Medicine, Yamadaoka 2-2, Suita City, Osaka 565-0871, Japan.
Insights
Integrated backscatter (IBS) and intima-media thickness (IMT) of the carotid artery can identify diabetic patients with recent acute coronary syndrome (ACS) or atherothrombotic infarction (ATI), indicating high cardiovascular disease risk.
Area of Science:
- Vascular biology and imaging
- Cardiovascular disease risk stratification
- Diabetology
Background:
- Type 2 diabetes is a significant risk factor for cardiovascular diseases.
- Carotid artery plaque characteristics may predict future cardiovascular events.
- Integrated backscatter (IBS) and intima-media thickness (IMT) are ultrasound-derived measures of carotid artery wall tissue.
Purpose of the Study:
- To determine if carotid artery wall tissue characterization using IBS can identify diabetic patients with recent acute coronary syndrome (ACS) or atherothrombotic infarction (ATI).
- To assess the association between carotid plaque size (Max-IMT) and tissue characteristics (corrected-IBS) with cardiovascular events in diabetic patients.
Main Methods:
- Ultrasonographic measurement of maximum intima-media thickness (Max-IMT) and corrected integrated backscatter (corrected-IBS) in 132 type 2 diabetic subjects.
- Comparison of carotid artery parameters between diabetic patients with and without recent cardiovascular diseases (ACS/ATI).
- Logistic regression analysis to identify predictors of recent ACS or ATI.
Main Results:
- Diabetic patients with recent ACS or ATI exhibited significantly lower corrected-IBS and higher Max-IMT compared to those without cardiovascular diseases.
- The product of Max-IMT and corrected-IBS (IMT-IBS product) was significantly lower in patients with recent ACS compared to those with stable angina.
- The IMT-IBS product was the sole significant predictor of a recent history of ACS (OR 0.94) and ATI (OR 0.90).
Conclusions:
- Diabetic patients with a recent history of ACS or ATI demonstrate altered carotid artery wall characteristics, specifically lower IBS values and increased IMT.
- Both the size and tissue composition of carotid plaques, as assessed by the IMT-IBS product, are valuable in identifying diabetic individuals at high risk for cardiovascular disease events.
Objective:
This study was conducted to examine whether tissue characterization of the carotid artery wall by determining integrated backscatter (IBS) can identify subjects with a recent history of acute coronary syndrome (ACS) or atherothrombotic infarction (ATI).
Research Design And Methods:
The maximum thickness (Max-IMT) and IBS value (corrected-IBS) of the carotid artery intima-media complex were measured ultrasonographically for 132 type 2 diabetic subjects (62.9+/-8.5 (+/-S.D.) years old, 87 men and 45 women) with or without cardiovascular diseases.
Results:
The diabetic patients with recent ACS or ATI had a significantly lower corrected-IBS and higher Max-IMT than those with Max-IMT > or = 1.1mm but without cardiovascular diseases. The product of Max-IMT and corrected-IBS (IMT-IBS product) of the patients with recent ACS was significantly lower than that of the patients with chronic stable angina. The multiple logistic model showed that only the IMT-IBS product was associated with a recent history of ACS (odds ratio 0.94, P<0.05) and ATI (odds ratio 0.90, P<0.005).
Conclusions:
Diabetic patients who had a recent history of ACS or ATI showed a lower IBS value and higher IMT for their carotid artery. Both the size and tissue characteristics of the carotid plaque may identify subjects with a high risk of cardiovascular disease.
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