Radial artery intima-media thickness predicts major cardiovascular events in patients with suspected coronary artery disease.

Abstract

AIMS:

In the present study, we investigated the prognostic value of radial artery intima-media thickness (rIMT) in patients with suspected coronary artery disease (CAD). Carotid artery intima-media thickness is a well-known surrogate marker of atherosclerosis. Recently, using very high-resolution ultrasound, we showed rIMT can be imaged with great precision and is related to various cardiovascular risk factors.

METHODS AND RESULTS:

We recruited a total of 416 patients (62 ± 9 years, 44% male) with suspected CAD, referred to myocardial perfusion scintigraphy (MPS). Among these patients, 133 underwent coronary angiography on clinical indication. Two-dimensional images of carotid and radial arteries were acquired bilaterally (using 8 and 55 MHz ultrasound, respectively). All patients were followed regarding major adverse cardiovascular events (MACE), including cardiovascular death, myocardial infarction, stroke, and coronary revascularization. A group of 20 healthy subjects (aged 61 ± 3, 50% male) were recruited for reference. During 3 years of follow-up, 77 MACE occurred. Patients with MACE exhibited significantly thicker rIMT vs. those without (0.35 ± 0.06 vs. 0.32 ± 0.07 mm, P < 0.001). Increased rIMT was associated with an increased occurrence of significant coronary artery narrowing, diagnosed by coronary angiography (P = 0.028). Patients with rIMT values above the median had a nearly three-fold increased risk for MACE (hazard ratio 2.8, 95% confidence interval 1.6-4.8). In multivariate analysis, rIMT (P = 0.011) remained a significant predictor of MACE, along with type II diabetes (P = 0.012), body mass index (P = 0.024), and MPS-verified ischaemia (P < 0.001).

CONCLUSION:

Radial artery IMT, assessed by very high-resolution ultrasound, confers prognostic information in patients with suspected CAD.

• Authors: Charlotte Eklund, Elmir Omerovic, Inger Haraldsson, Peter Friberg, Li-Ming Gan
• Journal: European heart journal. Cardiovascular Imaging (Eur Heart J Cardiovasc Imaging) Vol. 15 Issue 7 Pg. 769-75 (Jul 2014) ISSN: 2047-2412 [Electronic] England
• PMID: 24469155 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: [email protected].

Topics

• Acute Coronary Syndrome (diagnosis, epidemiology)
• Age Factors
• Aged
• Case-Control Studies
• Coronary Angiography (methods)
• Coronary Artery Disease (diagnostic imaging, epidemiology)
• Female
• Humans
• Incidence
• Kaplan-Meier Estimate
• Logistic Models
• Male
• Middle Aged
• Multivariate Analysis
• Myocardial Perfusion Imaging (methods)
• Predictive Value of Tests
• Prognosis
• Proportional Hazards Models
• Prospective Studies
• Radial Artery (diagnostic imaging)
• Reference Values
• Risk Assessment
• Severity of Illness Index
• Sex Factors
• Tunica Intima (diagnostic imaging, pathology)
• Tunica Media (diagnostic imaging, pathology)
• Ultrasonography, Interventional