Carotid Intima-Media Thickness Is Only Weakly Correlated With the Extent and Severity of Coronary Artery Disease

Adams, Mark; Nakagomi, Akihiro; Keech, Anthony; Robinson, JH; McCredie, Robyn J.; Bailey, Brian P.; Freedman, Ben; Celermajer, David S.

doi:10.1161/01.cir.92.8.2127

Cited by 366 publications

(282 citation statements)

References 52 publications

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“…However, it has been recognized that the association between increased carotid-artery intima-media thickness and coronary-artery atherosclerosis is weak (31), and the prevalence of coronary atherosclerosis in patients with RA and its relationship to disease duration and activity have remained unclear.…”

Section: Discussionmentioning

confidence: 99%

Increased coronary‐artery atherosclerosis in rheumatoid arthritis: Relationship to disease duration and cardiovascular risk factors

Chung¹,

Oeser²,

Raggi³

et al. 2005

Arthritis & Rheumatism

307

265

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Objective. To compare the prevalence and severity of coronary-artery atherosclerosis in patients with early and established rheumatoid arthritis (RA) and controls.Methods. Electron-beam computed tomography was used to measure the extent of coronary-artery calcification in 227 subjects, of whom 70 had early RA, 71 had established RA, and 86 were controls. Coronaryartery calcification calculated according to the Agatston calcium score was compared in patients and controls, and its relationship to clinical characteristics was examined. Adjusted odds ratios (ORs) were obtained with the use of proportional odds logistic regression models to determine independent associations of early and established RA and coronary-artery calcification.Results. Calcium scores were higher in patients with established RA (median 40.2, interquartile range [IQR] 0-358.8) compared with those with early disease (median 0, IQR 0-42.6) and controls (median 0, IQR 0-19.2) (P ‫؍‬ 0.001). Coronary-artery calcification occurred more frequently in patients with established RA (60.6%) than in patients with early RA (42.9%) and control subjects (38.4%) (P ‫؍‬ 0.016) The OR for the likelihood of having more severe coronary-artery calcification (defined as an Agatston score >109) in patients with established disease was 3.42 (P ‫؍‬ 0.002) after adjusting for cardiovascular risk factors. Among patients with RA, smoking (OR 1.02, P ‫؍‬ 0.04) and an elevated erythrocyte sedimentation rate (OR 1.02, P ‫؍‬ 0.05) were associated with more severe coronary-artery calcification after adjustment for age and sex.Conclusion. The prevalence and severity of coronary calcification is increased in patients with established RA and is related, in part, to smoking and an increased erythrocyte sedimentation rate.

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Section: Discussionmentioning

confidence: 99%

Increased coronary‐artery atherosclerosis in rheumatoid arthritis: Relationship to disease duration and cardiovascular risk factors

Chung¹,

Oeser²,

Raggi³

et al. 2005

Arthritis & Rheumatism

307

265

View full text Add to dashboard Cite

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“…IMT primarily represents medial hypertrophy related to hypertension [24,25], and the association between IMT and CHD was weak in several studies [26,27]. CPA was claimed to be a better predictor of coronary atherosclerosis than other noninvasive methods [11,28].…”

Section: Discussionmentioning

confidence: 99%

Proinsulin:insulin and insulin:glucose ratios as predictors of carotid plaque growth: a population-based 7 year follow-up of the Tromsø Study

et al. 2007

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Aims/hypothesis Proinsulin is increased in persons at cardiovascular risk. Increased secretion of proinsulin relative to insulin has been suggested as a sign of defective conversion of proinsulin to insulin and C-peptide and is associated with beta cell dysfunction. It has also been suggested that proinsulin has more of a pro-atherogenic effect than insulin, the levels of which are also increased in the insulin resistance state. In this prospective populationbased study, we examined whether the proinsulin:insulin ratio (PIR) or insulin:glucose ratio (IGR, an insulin resistance surrogate) predicted carotid plaque size in nondiabetic participants. Materials and methods The study included 1,859 men and 1,998 women aged 25-82 years from the Tromsø Study, who were examined with B-mode high resolution ultrasound at baseline in 1994-1995 and at follow-up in [2001][2002]. All images were computer processed to yield mm 2 measures of plaque. Proinsulin and insulin were measured at baseline. All analyses were stratified for sex. Results After adjusting for age, baseline plaque area, BMI, cholesterol, HDL-cholesterol, HbA 1c , IGR, albumin:creatinine ratio, fibrinogen, BP and lifestyle factors (tobacco smoking, alcohol consumption, physical activity), PIR was significantly associated with plaque size at follow-up in women but not men. For each SD in the PIR in women, the mean plaque area increased by 0.97 mm 2 (95% CI 0.44-1.50). IGR was not associated with carotid plaque size. Conclusions/interpretation The PIR is associated with progressive carotid artery plaque size in women.

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“…The small size also limits use of WHHL rabbit arteries in the development of human cardiovascular devices such as stents. Moreover, plaque in a main aortic branch such as the carotid artery is not similar to and only weakly correlated with plaque in the coronary artery 4. For investigation into the development of coronary artery plaques, especially advanced plaques, an animal model with human‐like coronary arteries is needed.…”

Section: Introductionmentioning

confidence: 99%

Development of Human‐Like Advanced Coronary Plaques in Low‐Density Lipoprotein Receptor Knockout Pigs and Justification for Statin Treatment Before Formation of Atherosclerotic Plaques

Fuchimoto

Sudo

et al. 2016

JAHA

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BackgroundAlthough clinical trials have proved that statin can be used prophylactically against cardiovascular events, the direct effects of statin on plaque development are not well understood. We generated low‐density lipoprotein receptor knockout (LDLR −/−) pigs to study the effects of early statin administration on development of atherosclerotic plaques, especially advanced plaques.Methods and Results LDLR −/− pigs were generated by targeted deletion of exon 4 of the LDLR gene. Given a standard chow diet, LDLR −/− pigs showed atherosclerotic lesions starting at 6 months of age. When 3‐month‐old LDLR −/− pigs were fed a high‐cholesterol, high‐fat (HCHF) diet for 4 months (HCHF group), human‐like advanced coronary plaques developed. We also fed 3‐month‐old LDLR −/− pigs an HCHF diet with pitavastatin for 4 months (Statin Prophylaxis Group). Although serum cholesterol concentrations did not differ significantly between the 2 groups, intravascular ultrasound revealed 52% reduced plaque volume in statin‐treated pigs. Pathological examination revealed most lesions (87%) in the statin prophylaxis group were early‐stage lesions, versus 45% in the HCHF diet group (P<0.01). Thin‐cap fibroatheroma characterized 40% of the plaques in the HCHF diet group versus 8% in the statin prophylaxis group (P<0.01), intraplaque hemorrhage characterized 11% versus 1% (P<0.01), and calcification characterized 22% versus 1% (P<0.01).ConclusionsResults of our large animal experiment support statin prophylaxis before the occurrence of atherosclerosis. Early statin treatment appears to retard development of coronary artery atherosclerosis and ensure lesion stability. In addition, the LDLR −/− pigs we developed represent a large animal model of human‐like advanced coronary plaque suitable for translational research.

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Carotid Intima-Media Thickness Is Only Weakly Correlated With the Extent and Severity of Coronary Artery Disease

Abstract: Although carotid IMT is significantly correlated with extent and severity of CAD, the relationship is weak. This relatively poor correlation (r2 < .10) should be considered in the interpretation of clinical trials that use carotid IMT as a surrogate end point for coronary atherosclerosis.

Cited by 366 publications

References 52 publications

Increased coronary‐artery atherosclerosis in rheumatoid arthritis: Relationship to disease duration and cardiovascular risk factors

Increased coronary‐artery atherosclerosis in rheumatoid arthritis: Relationship to disease duration and cardiovascular risk factors

Proinsulin:insulin and insulin:glucose ratios as predictors of carotid plaque growth: a population-based 7 year follow-up of the Tromsø Study

Development of Human‐Like Advanced Coronary Plaques in Low‐Density Lipoprotein Receptor Knockout Pigs and Justification for Statin Treatment Before Formation of Atherosclerotic Plaques

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