Biomedical Science Letters (대한의생명과학회지)

The Korean Society for Biomedical Laboratory Sciences (대한의생명과학회)
권호 표지
DOI QR코드

DOI QR Code

The Comparison of Carotid Artery Intima-media Thickness and Plaque Characteristics between Patients with ST-elevation Myocardial Infarction and Coronary Artery Chronic Total Occlusion

  • Choi, Sun Young (Department of Cardiology, Dong-A University Medical Center) ;
  • Park, Jong Sung (Department of Cardiology, Dong-A University Medical Center)
  • Received : 2015.10.29
  • Accepted : 2015.11.13
  • Published : 2015.12.31
Download PDF
⟨ Previous Next ⟩

Abstract

ST-segment elevation myocardial infarction (STEMI) and chronic total occlusion (CTO) of coronary artery are well-known atherosclerotic vascular diseases. However, the difference of intima-media thickness and plaque characteristics of carotid arteries between STEMI and CTO patients were not directly compared in previous studies. Medical records of a total of 158 (101 STEMI, 57 CTO) patients, who underwent carotid artery ultrasonography, were selected for the analysis. The baseline characteristics, ultrasonography findings, and clinical outcomes of the two groups were compared. The prevalence of hypertension, diabetes mellitus, and dyslipidemia was significantly higher in CTO patients. Carotid intima-media thickness ($0.97{\pm}0.13$ vs. $0.78{\pm}0.17cm$, P < 0.0001) and number of plaques ($2.2{\pm}1.0$ vs. $1.7{\pm}1.2$, P < 0.0001) were greater in CTO than STEMI patients. Multiple (${\geq}3$) or echogenic plaques were more frequently observed in CTO patients. During the median follow-up duration of 27 months, major adverse cardiovascular events occurred in 31% of CTO and 14% of STEMI patients (P = 0.008). We found that, compared with STEMI, CTO patients have higher burden of carotid artery atherosclerosis associated with more comorbid diseases and poor clinical outcomes.

Keywords

References

  1. Amato M, Montorsi P, Ravani A, Oldani E, Galli S, Ravagnani PM, Tremoli E, Baldassarre D. Carotid intima-media thickness by B-mode ultrasound as surrogate of coronary atherosclerosis: correlation with quantitative coronary angiography and coronary intravascular ultrasound findings. Eur Heart J. 2007. 28: 2094-2101. https://doi.org/10.1093/eurheartj/ehm244
  2. Aldridge ME, Do K, Oo T, Naqvi TZ. Carotid intima-media thickness and plaque assessment by trained medical residents: validation and preliminary testing of a training protocol. J Am Soc Echocardiogr. 2013. 26: 1457-1464. https://doi.org/10.1016/j.echo.2013.08.009
  3. Bots ML, Breslau PJ, Briët E, de Bruyn AM, van Vliet HH, van den Ouweland FA, de Jong PT, Hofman A, Grobbee DE. Cardiovascular determinants of carotid artery disease: the Rotterdam Elderly Study. Hypertension. 1992. 19: 717-720. https://doi.org/10.1161/01.HYP.19.6.717
  4. Belcaro G, Nicolaides AN, Laurora G, Cesarone MR, De Sanctis M, Incandela L, Barsotti A. Ultrasound morphology classification of the arterial wall and cardiovascular events in a 6-year follow-up study. Arterioscler Thromb Vasc Biol. 1996. 16: 851-856. https://doi.org/10.1161/01.ATV.16.7.851
  5. Dohi T, Daida H. Change of concept and pathophysiology in acute coronary syndrome. Nihon Rinsho. 2010. 68: 592-596.
  6. Heiss G, Sharett AR, Barnes R, Chambless LE, Szklo M, Alzola C, and the ARIC Investigators. Carotid atherosclerosis measured by B-mode ultrasound in populations: associations with cardiovascular risk factors in the ARIC study. Am J Epidemiol. 1991. 134: 250-256. https://doi.org/10.1093/oxfordjournals.aje.a116078
  7. Hegele RA. The pathogenesis of atherosclerosis. Clin Chim Acta. 1996. 246: 21-38. https://doi.org/10.1016/0009-8981(96)06224-9
  8. Johnsen SH, Mathiesen EB, Joakimsen O, Stensland E, Wilsgaard T, Lochen ML, Njolstad I, Arnesen E. Carotid atherosclerosis is a stronger predictor of myocardial infarction in women than in men: a 6-year follow-up study of 6226 persons: the Troms. Stroke. 2007. 38: 2873-2880. https://doi.org/10.1161/STROKEAHA.107.487264
  9. Lorenz MW, Markus HS, Bots ML, Rosvall M, Sitzer M. Prediction of clinical CVEs with carotid intima-media thickness: a systematic review and meta-analysis. Circulation. 2007. 115: 459-467. https://doi.org/10.1161/CIRCULATIONAHA.106.628875
  10. Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA, Picard MH, Roman MJ, Seward J, Shanewise JS, Solomon SD, Spencer KT, Sutton MS, Stewart WJ; Chamber Quantification Writing Group; American Society of Echocardiography's Guidelines and Standards Committee; European Association of Echocardiography. Recommendations for chamber quantification. J Am Soc Echocardiogr. 2005. 18: 1440-1463. https://doi.org/10.1016/j.echo.2005.10.005
  11. Mannami T, Konishi M, Baba S, Nishi N, Terao A. Prevalence of asymptomatic carotid atherosclerotic lesions detected by high-resolution ultrasonography and its relation to cardiovascular risk factors in the general population of a Japanese city: the Suita study. Stroke. 1997. 28: 518-525. https://doi.org/10.1161/01.STR.28.3.518
  12. Mancia G, De Backer G, Dominiczak A, Cifkova R, Fagard R, Germano G, Grassi G, Heagerty AM, Kjeldsen SE, Laurent S, Narkiewicz K, Ruilope L, Rynkiewicz A, Schmieder RE, Boudier HA, Zanchetti A, Vahanian A, Camm J, De Caterina R, Dean V, Dickstein K, Filippatos G, Funck-Brentano C, Hellemans I, Kristensen SD, McGregor K, Sechtem U, Silber S, Tendera M, Widimsky P, Zamorano JL, Erdine S, Kiowski W, Agabiti-Rosei E, Ambrosioni E, Lindholm LH, Viigimaa M, Adamopoulos S, Agabiti-Rosei E, Ambrosioni E, Bertomeu V, Clement D, Erdine S, Farsang C, Gaita D, Lip G, Mallion JM, Manolis AJ, Nilsson PM, O'Brien E, Ponikowski P, Redon J, Ruschitzka F, Tamargo J, van Zwieten P, Waeber B, Williams B; Management of Arterial Hypertension of the European Society of Hypertension; European Society of Cardiology. 2007 Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens. 2007. 25: 1105-1187. https://doi.org/10.1097/HJH.0b013e3281fc975a
  13. O'Leary DH, Polak JF, Kronmal RA, Kittner SJ, Bond MG, Wolfson SK Jr, Bommer W, Price TR, Gardin JM, Savage PJ. Distribution and correlates of sonographically detected carotid artery disease in the Cardiovascular Health Study. Stroke. 1992. 23: 1752-1760. https://doi.org/10.1161/01.STR.23.12.1752
  14. O'Leary DH, Polak JF, Kronmal RA, Savage PJ, Borhani NO, Kittner SJ, Tracy R, Gardin JM, Price TR, Furberg CD. Thickening of the carotid wall. A marker for atherosclerosis in the elderly? Cardiovascular Health Study Collaborative Research Group. Stroke. 1996. 27: 224-231. https://doi.org/10.1161/01.STR.27.2.224
  15. O'Leary DH, Polak JF, Kronmal RA, Manolio TA, Burke GL, Wolfson SK Jr. Carotid-artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults. Cardiovascular Health Study Collaborative Research Group. N Engl J Med. 1999. 340: 14-22. https://doi.org/10.1056/NEJM199901073400103
  16. Ommen SR1, Nishimura RA, Appleton CP, Miller FA, Oh JK, Redfield MM, Tajik AJ. Clinical utility of Doppler echocardiography and tissue Doppler imaging in the estimation of left ventricular filling pressures: a comparative simultaneous Doppler catheterization study. Circulation. 2000. 102: 1788 -1794. https://doi.org/10.1161/01.CIR.102.15.1788
  17. Salonen R, Salonen JT. Determinants of carotid intima-media thickness: a population-based ultrasonography study in eastern Finnish men. J Intern Med. 1991. 229: 225-231. https://doi.org/10.1111/j.1365-2796.1991.tb00336.x
  18. Spence JD, Eliasziw M, DiCicco M, Hackam DG, Galil R, Lohmann T. Carotid plaque area: a tool for targeting and evaluating vascular preventive therapy. Stroke. 2002. 33: 2916-2922. https://doi.org/10.1161/01.STR.0000042207.16156.B9
  19. Stone GW, Kandzari DE, Mehran R, Colombo A. Schwartz RS, Bailey S, Moussa I, Teirstein PS, Dangas G, Baim DS, Selmon M, Strauss BH, Tamai H, Suzuki T, Mitsudo K, Katoh O, Cox DA, Hoye A, Mintz GS, Grube E, Cannon LA, Reifart NJ, Reisman M, Abizaid A, Moses JW, Leon MB, Serruys PW. Percutaneous recanalization of chronically occluded coronary arteries: a consensus document: part I. Circulation. 2005. 112: 2364-2372. https://doi.org/10.1161/CIRCULATIONAHA.104.481283
  20. Su TC, Jeng JS, Chien KL, Torng PL, Sung FC, Lee YT. Measurement reliability of common carotid artery intima-media thickness by ultrasonographic assessement. J Med Ultrasound. 1999. 7: 73-79.
  21. Tsujita K, Kaikita K, Soejima H, Sugiyama S, Ogawa H. Acute coronary syndrome-initiating factors. Nihon Rinsho. 2010. 68: 607-614.
  22. Wendelhag I, Olov G, Wikstrand J. Arterial wall thickness in familial hypercholesterolemia: ultrasound measurement of intima-media thickness in the common carotid artery. Arterioscler Thromb. 1992. 12: 70-77. https://doi.org/10.1161/01.ATV.12.1.70