Carotid plaque and intima-media thickness and the incidence of ischemic events in patients with atherosclerotic vascular disease

Keo, Hong H; Baumgartner, Iris; Hirsch, Alan T; Duval, Sue; Steg, Ph Gabriel; Pasquet, Blandine; Bhatt, Deepak L; Roether, Joachim; for the REACH Registry Investigators, (2011). Carotid plaque and intima-media thickness and the incidence of ischemic events in patients with atherosclerotic vascular disease. Vascular medicine, 16(5), pp. 323-330. London: Sage 10.1177/1358863X11419997

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We aimed to evaluate whether carotid intima-media thickness (CIMT) or the presence of plaque can confer additional predictive value of future cardiovascular (CV) ischemic events in patients with pre-existing atherosclerotic vascular disease. We identified 2317 patients enrolled in the REduction of Atherothrombosis for Continued Health (REACH) registry who had atherosclerotic vascular disease and baseline CIMT measurements. The entire range of CIMT was divided into quartiles and the fourth quartile (? 1.5 mm) was defined as carotid plaque. Mean ± standard deviation baseline CIMT was 1.31 ± 0.65 mm. Associated CV ischemic events and vascular-related hospitalizations were evaluated over a 2-year follow-up. There was a positive increase in adjusted hazard ratios (HRs) for all-cause mortality (p = 0.04 for trend) and the quadruple endpoint (CV death, myocardial infarction (MI), stroke, hospitalization for CV events) with increasing quartiles of CIMT (p = 0.0008 for trend), which was mainly driven by the fourth quartile (carotid plaque). HRs for all-cause mortality, CV death, CV death/MI/stroke and the quadruple endpoint comparing the highest (carotid plaque) with the lowest CIMT quartile were 2.09 (95% CI, 1.07-4.10; p = 0.03); 2.49 (1.10-5.67; p = 0.03); 1.71 (1.10-2.67; p = 0.02); and 1.73 (1.31-2.27; p = 0.0001). In conclusion, our analyses suggest that the presence of carotid plaque, rather than the thickness of intima-media, appears to be associated with increased risk of CV morbidity and mortality, but confirmation of these findings in other population and prospective studies is required.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Angiology
UniBE Contributor:	Baumgartner, Iris
ISSN:	1358-863X
Publisher:	Sage
Language:	English
Submitter:	Factscience Import
Date Deposited:	04 Oct 2013 14:15
Last Modified:	05 Dec 2022 14:03
Publisher DOI:	10.1177/1358863X11419997
PubMed ID:	21908682
Web of Science ID:	000295880400001
URI:	https://boris.unibe.ch/id/eprint/4282 (FactScience: 208442)