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International Angiology 2001 March;20(1):38-46


lingua: Inglese

Interchangeability of carotid and femoral intima-media thickness in risk stratification

Rietzschel E. R. 1, 2, De Buyzere M. L. 1, Duprez D. A. 1, Clement D. L. 1

From the 1 Department of Cardiology and Angiology, Ghent University Hospital, Ghent Belgium 2 Fund for Scientific Research-Flanders


Back­ground. Carot­id inti­ma-media thick­ness (c-IMT) is an inter­me­di­ate phe­no­type not only for the local but also the glo­bal arte­rio­scle­rot­ic stat­us, a con­cept which has been val­i­dat­ed by its abil­ity to act as a mark­er for ­future car­di­o­vas­cu­lar and cereb­ro­vas­cu­lar ­events. Wheth­er the asso­ci­a­tion ­between c-IMT and risk fac­tors, dis­tant ath­e­ros­cle­rot­ic dis­ease and prog­no­sis are the sole pre­rog­a­tive of the carot­id ­artery, or wheth­er these find­ings can be extrap­o­lat­ed to other arte­ri­al sites is less well stud­ied. In view of the con­cept of vas­cu­lar het­ero­ge­ne­ity, we meas­ured the IMT in a mus­cu­lar, lower extrem­ity ­artery, the com­mon femo­ral (f-IMT), and in elas­tic upper extrem­ity ­artery, the com­mon carot­id, in appar­ent­ly ­healthy indi­vid­u­als and ­explored the rela­tion­ship with risk fac­tors and the ­individuals’ 10-year car­di­o­vas­cu­lar (CV) risk, cal­cu­lat­ed using the Fram­ing­ham sys­tol­ic blood pres­sure equa­tion.
Meth­ods. A pop­u­la­tion of 156 appar­ent­ly ­healthy nor­mo­ten­sive Cau­ca­sian vol­un­teers ­between 18 and 65 years was stud­ied (mean age 43±13 years; 68 men, 88 women; mean arte­ri­al blood pres­sure 126±15/70±10 mmHg). The c-IMT and f-IMT were meas­ured using a 10 MHz vas­cu­lar lin­e­ar array trans­duc­er at the far walls 1 to 2 cen­ti­me­tres prox­i­mal to the right com­mon carot­id and right com­mon femo­ral ­artery bifur­ca­tions, respec­tive­ly. Risk fac­tors were ­assessed and the 10-year car­di­o­vas­cu­lar risk was cal­cu­lat­ed using the Fram­ing­ham sys­tol­ic blood pres­sure equa­tion.
­Results. The ­median c-IMT was 0.52 mm (inter­quar­tile range 0.45-0.62 mm) and f-INT was 0.52 mm (0.39-0.67). Both param­e­ters were sig­nif­i­cant­ly cor­re­lat­ed (r=0.363; p<0.01) and both were sig­nif­i­cant­ly cor­re­lat­ed to the cal­cu­lat­ed 10-year CV risk (r=0.579; p<0.01 and r=0.574; p<0.01 for the carot­id and c-IMT and f-IMT, respec­tive­ly). ­Median risk was low: 2.11% (0.27-5.50). ­Although meas­ures of agree­ment were high­er for the f-IMT ver­sus risk (0.47) than for the c-IMT ver­sus risk (0.30), the for­mer ­showed a sig­nif­i­cant­ly wider scat­ter with increas­ing age and with quar­tiles of CV risk. The c-IMT and f-IMT do not share deter­mi­nant risk fac­tors to the same ­extent and with only 20% of mutu­al var­i­ance ­explained, can­not be regard­ed as inter­change­able.
Con­clu­sions. ­Although the c-IMT and f-IMT are sig­nif­i­cant­ly inter­cor­re­lat­ed and cor­re­late to the cal­cu­lat­ed 10-year CV risk, they are not inter­change­able. While the f-IMT is less suit­ed as a con­tin­u­ous var­i­able for risk strat­ifi­ca­tion in a low-risk pop­u­la­tion, our data sug­gest its pos­sible use as a dichot­om­ised risk mark­er.

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