Appropriateness of carotid plaque and intima-media thickness assessment in routine clinical practice

Abstract

Objectives: To describe the findings and evaluate appropriateness of a carotid artery study including the measurement of IMT, the presence of atherosclerotic plaque, and their correlation with cardiovascular risk factors.Methods: 555 patients (220 men; 67.06 ± 12.44 years) were included in the study. 120 patients (21.62%) presented carotid plaque: 108 (19.45%) in patients with at least one risk factor and 12 (2.1%) in patients without risk factors. With respect to appropriateness of the present studies: 65% were appropriate, 22% were uncertain and 13% were inappropriate. The IMT medians were higher in males (0.0280; 95% CI, 00.82 to 0.478; p = 0.0057) and in hypertensive patients (0.391; 95% CI, 0.0190 to 0.0592; p = 0,001). There was a linear increase in mean IMT for each year increased in age (0.0059; 95% CI; 0.0050 to 0.0067). Carotid plaque was more frequent in patients with CAD (p = 0.0002), diabetes (p = 0.024) and hypertension (p = 0.036). Conclusion:Assessment of carotid arteries identified increased incidence of plaque in patients with CAD, diabetes and hypertension. IMT was increased in older patients, hypertensive patients and males. Forty-five percent of the patients were studied based on uncertain and inappropriate reasons.

Relation between cardiovascular disease risk factors and common carotid artery intima media thickness

“…Th e mean CCA IMT increased with confi rm this hypothesis 21,31 . As was determined in the present study, the literature comprises the studies that reveal positive correlation between male gender and carotid IMT 7,10,11 . However, there are studies suggesting that gender has no eff ect on carotid IMT.…”

“…In addition to the researchers in the literature stating that DM increases carotid IMT, there are also researchers reporting no relation 7,15,16,39,40 . In the present study, univariate analyses demonstrated that DM is among the risk factors eff ective on carotid IMT; whereas, regression analysis revealed no signifi cant eff ect of DM on carotid IMT.…”

“…In the present study, we as well found signifi cant relation between carotid IMT and active smoking. Besides, there are studies in the literature stating that smoking does not infl uence carotid IMT 7,19 . In their study, Oren et al stated that smoking does not infl uence carotid IMT and they related with their sample characteristics consisting of young participants aged 27-30 years 19 .…”

“…Age is among unchangeable factors that contribute to the development and progression of atherosclerosis 21 and the positive correlation between age and carotid atherosclerosis is increasingly being emphasized [6][7][8] . Consistent with the literature, the present study demonstrated that IMT increased with age.…”

“…It is stated that there was a relation between myocardial infarction (MI), stroke and coronary artery disease (CAD) related deaths and carotid IMT 4 . Th e relation between carotid IMT and traditional cardiovascular risk factors such as age, gender, hypertension (HT), diabetes mellitus (DM), hyperlipidemia and smoking in addition to CAD and cerebrovascular disease (CVD) was studied previously [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] . However, results of these studies are confl icting.…”