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[Carotid artery atherosclerosis in patients with myocardial infarction]
Y Yamamoto1, S Yamano, S Minami
1First Department of Internal Medicine, Nara Medical University.
Insights
Patients with myocardial infarction frequently have severe carotid artery atherosclerosis, which worsens with the extent of coronary artery disease. This finding highlights the link between heart and artery health.
Area of Science:
- Cardiovascular Medicine
- Vascular Biology
- Diagnostic Imaging
Context:
- Myocardial infarction (MI) is a leading cause of mortality globally.
- Carotid artery atherosclerosis is a significant risk factor for stroke.
- The relationship between MI and carotid atherosclerosis severity requires further elucidation.
Purpose:
- To investigate the prevalence and severity of carotid artery atherosclerosis in patients with acute myocardial infarction.
- To correlate carotid intima-media thickness (IMT) with the extent of coronary artery disease.
Summary:
- This study measured carotid intima-media complex thickness (IMT) in 102 patients with myocardial infarction (MI) and 55 controls.
- Patients with MI exhibited significantly greater mean carotid IMT (sigma IMT) compared to controls.
- Carotid atherosclerosis severity, indicated by sigma IMT and prevalence, increased with the number of diseased coronary vessels.
Impact:
- Carotid artery atherosclerosis is a common and severe complication in patients with myocardial infarction.
- The findings underscore the importance of assessing carotid atherosclerosis in MI patients, particularly those with multi-vessel coronary disease.
- This research may inform risk stratification and management strategies for cardiovascular patients.
Abstract:
This study investigated carotid artery atherosclerosis in patients with myocardial infarction. One hundred and two patients with acute myocardial infarction [Group MI: male 86, female 16, mean 62 (range 43-79) years] and 55 normal subjects matched for age and sex with negative responses to exercise electrocardiogram testing (control group: Group C) were included. Patients in Group MI were divided into 3 subgroups according to coronary angiographic findings as follows: 57 patients with one-vessel disease (Group I: mean 59 years), 34 with 2-vessel disease (Group II: mean 64 years), and 11 with 3-vessel disease (Group III: mean 64 years). Intima-media complex thickness (IMT) of the bilateral common carotid arteries (15 mm proximal to the bifurcation) and the internal carotid arteries (15 mm distal to the bifurcation) were measured by high-resolution B-mode ultrasonography, and the sum of maximum IMT of the bilateral carotid arteries (sigma IMT) were calculated. sigma IMT was significantly greater in Group MI (2.5 +/- 0.5 mm) than in Group C (1.8 +/- 0.3 mm), sigma IMT was 2.5 +/- 0.5 in Group I, 2.6 +/- 0.5 in Group II, and 2.7 +/- 0.4 mm in Group III. There was a significant positive correlation between sigma IMT and the number of involved vessels (tau = 0.45, p < 0.01). The percentage of patients with carotid artery atherosclerosis was 2% in Group C, 63% in Group MI, 54% in Group I, 68% in Group II, and 82% in Group III (p < 0.001). This study suggests that carotid artery atherosclerosis in patients with myocardial infarction is frequently complicated and severe, and more frequently complicated in patients with severe coronary artery disease.