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Associations of Coronary Heart Disease with Common Carotid Artery Near and Far Wall Intima-Media Thickness: The Multi-Ethnic Study of Atherosclerosis.
J Am Soc Echocardiogr. 2015 Sep; 28(9):1114-21.JA

Abstract

BACKGROUND

Intima-media thickness (IMT) measured on ultrasound images of the common carotid artery (CCA) is associated with cardiovascular risk factors and events. Given the physics of ultrasound, CCA far wall IMT measurements are favored over near wall measurements, but this theoretical advantage is not well studied.

METHODS

A total of 6,606 members of the Multi-Ethnic Study of Atherosclerosis, a longitudinal cohort study (mean age, 62.1 years; 52.7% women) who had near wall and far wall CCA IMT measurements. Multivariate linear regression models were used to estimate model goodness of fit of Framingham risk factors with near wall IMT, far wall IMT, and combined mean IMT. Multivariate Cox proportional hazards models were used to estimate hazard ratios for incident coronary heart disease events for each IMT variable. Change in Harrell's C statistic was used to compare the incremental value of each IMT variable when added to Framingham risk factors.

RESULTS

Mean IMT had the strongest association with risk factors (R(2) = 0.31), followed by near wall (R(2) = 0.26) and far wall (R(2) = 0.22) IMT. Far wall IMT improved the prediction of coronary artery disease events over the Framingham risk factors (change in C statistic, 0.012; 95% CI, 0.006-0.017; P < .001), as did mean IMT (P = .004), but near wall IMT did not.

CONCLUSIONS

Far wall CCA IMT showed the strongest association with incident coronary heart disease, whereas mean IMT had the strongest associations with risk factors. This difference might affect the selection of appropriate IMT variables in different studies.

Authors+Show Affiliations

Ultrasound Reading Center, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts. Electronic address: jpolak@tuftsmedicalcenter.org.Department of Epidemiology, Johns Hopkins University, Baltimore, Maryland.Department of Radiology, Saint Elizabeth's Medical Center, Tufts University School of Medicine, Boston, Massachusetts.

Pub Type(s)

Journal Article
Multicenter Study
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

25944425

Citation

Polak, Joseph F., et al. "Associations of Coronary Heart Disease With Common Carotid Artery Near and Far Wall Intima-Media Thickness: the Multi-Ethnic Study of Atherosclerosis." Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography, vol. 28, no. 9, 2015, pp. 1114-21.
Polak JF, Szklo M, O'Leary DH. Associations of Coronary Heart Disease with Common Carotid Artery Near and Far Wall Intima-Media Thickness: The Multi-Ethnic Study of Atherosclerosis. J Am Soc Echocardiogr. 2015;28(9):1114-21.
Polak, J. F., Szklo, M., & O'Leary, D. H. (2015). Associations of Coronary Heart Disease with Common Carotid Artery Near and Far Wall Intima-Media Thickness: The Multi-Ethnic Study of Atherosclerosis. Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography, 28(9), 1114-21. https://doi.org/10.1016/j.echo.2015.04.001
Polak JF, Szklo M, O'Leary DH. Associations of Coronary Heart Disease With Common Carotid Artery Near and Far Wall Intima-Media Thickness: the Multi-Ethnic Study of Atherosclerosis. J Am Soc Echocardiogr. 2015;28(9):1114-21. PubMed PMID: 25944425.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Associations of Coronary Heart Disease with Common Carotid Artery Near and Far Wall Intima-Media Thickness: The Multi-Ethnic Study of Atherosclerosis. AU - Polak,Joseph F, AU - Szklo,Moyses, AU - O'Leary,Daniel H, Y1 - 2015/05/02/ PY - 2014/08/22/received PY - 2015/5/7/entrez PY - 2015/5/7/pubmed PY - 2016/6/10/medline KW - Carotid artery bifurcation KW - Common carotid artery KW - Coronary heart disease KW - Intima-media thickness KW - Risk factors KW - Ultrasound SP - 1114 EP - 21 JF - Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography JO - J Am Soc Echocardiogr VL - 28 IS - 9 N2 - BACKGROUND: Intima-media thickness (IMT) measured on ultrasound images of the common carotid artery (CCA) is associated with cardiovascular risk factors and events. Given the physics of ultrasound, CCA far wall IMT measurements are favored over near wall measurements, but this theoretical advantage is not well studied. METHODS: A total of 6,606 members of the Multi-Ethnic Study of Atherosclerosis, a longitudinal cohort study (mean age, 62.1 years; 52.7% women) who had near wall and far wall CCA IMT measurements. Multivariate linear regression models were used to estimate model goodness of fit of Framingham risk factors with near wall IMT, far wall IMT, and combined mean IMT. Multivariate Cox proportional hazards models were used to estimate hazard ratios for incident coronary heart disease events for each IMT variable. Change in Harrell's C statistic was used to compare the incremental value of each IMT variable when added to Framingham risk factors. RESULTS: Mean IMT had the strongest association with risk factors (R(2) = 0.31), followed by near wall (R(2) = 0.26) and far wall (R(2) = 0.22) IMT. Far wall IMT improved the prediction of coronary artery disease events over the Framingham risk factors (change in C statistic, 0.012; 95% CI, 0.006-0.017; P < .001), as did mean IMT (P = .004), but near wall IMT did not. CONCLUSIONS: Far wall CCA IMT showed the strongest association with incident coronary heart disease, whereas mean IMT had the strongest associations with risk factors. This difference might affect the selection of appropriate IMT variables in different studies. SN - 1097-6795 UR - https://www.unboundmedicine.com/medline/citation/25944425/Associations_of_Coronary_Heart_Disease_with_Common_Carotid_Artery_Near_and_Far_Wall_Intima_Media_Thickness:_The_Multi_Ethnic_Study_of_Atherosclerosis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0894-7317(15)00268-0 DB - PRIME DP - Unbound Medicine ER -