Carotid Intima-Media Thickness Is Associated with Long-Term Mortality in Patients with Non-ST Segment Elevation...

Background: There is insufficient data in the literature on the relationship between carotid intima-media thickness (cIMT) measured in non-ST segment elevation myocardial infarction (NSTEMI) and cardiovascular (CV) mortality. Therefore, we aimed to determine the effect of cIMT value on long-term mortality in patients with NSTEMI. Methods: This retrospective cohort study included 279 patients with NSTEMI. In addition to clinical, demographic, laboratory, and angiographic investigations, cIMT, femoral IMT (fIMT), and aortic IMT (aIMT) were measured by B-mode ultrasonography. All patients received follow-up evaluation for CV mortality. The patients were grouped as with and without mortality. Results: Patients with NSTEMI received follow-up evaluations for 7.51 ± 0.85 years and 77 (27.6%) patients had mortality. Age, creatinine, blood urea nitrogen, cIMT, aIMT, fIMT, and SYNTAX score values were significantly higher in patients with mortality compared to patients without mortality. Hemoglobin, total cholesterol, LDL cholesterol, triglyceride levels, and left ventricular ejection fraction were significantly lower in patients with mortality compared to patients without mortality. In multivariate analysis, cIMT, age, and creatinine level were found to be independent predictors of mortality. Among these parameters, an increase in age (each year), carotid IMT (each 0.1 mm), and serum creatinine (each 0.1 mg/L) levels predicted an increase in mortality by 8%, 46.5%, and 12.6%, respectively. In ROC analysis, age, cIMT, and creatinine level were found to determine the development of mortality due to NSTEMI with acceptable sensitivity and specificity when an age of 65 years, 0.80 mm, and 0.90 mg/L were taken as cut-off values, respectively. Discussion: In patients with NSTEMI, cIMT measurement is independently associated with the development of long-term mortality.