Maryam Zaid1,2, Akira Fujiyoshi3,4, Takashi Hisamatsu5, Aya Kadota2, Sayaka Kadowaki3, Atsushi Satoh6, Akira Sekikawa7, Emma Barinas-Mitchell7,8, Minoru Horie9, Katsuyuki Miura2,3, Hirotsugu Ueshima2,3. 1. Department of Epidemiology, School of Public Health, Fudan University. 2. Center for Epidemiologic Research in Asia, Shiga University of Medical Science. 3. Department of Public Health, Shiga University of Medical Science. 4. Department of Hygiene, Wakayama Medical University. 5. Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine. 6. Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University. 7. Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh. 8. Clinical Translational Science Institute, University of Pittsburgh. 9. Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science.
Abstract
AIMS: The utility of carotid intima-media thickness (cIMT) as a marker for coronary heart disease is under heavy debate. This is predominantly due to the lack of a standard definition of cIMT, leading to inconsistent results. We investigated and compared the relationships of five different measures of cIMT with coronary calcium. METHODS: Japanese men aged 40-79y ( n=869) from Shiga Epidemiological Study of Subclinical Atherosclerosis were examined. Mean cIMT was measured in three segments of the carotid arteries: common carotid artery (CCAmean), internal carotid artery (ICAmean) and bifurcation (Bifmean). Mean cIMT of average values (Mean cIMT) and mean cIMT of maximum values (Mean-Max cIMT) of all segments combined were assessed. Coronary calcium was assessed as coronary artery calcification (CAC). Ordinal logistic regression was used to determine the odds ratio (OR) of higher CAC per 1 standard deviation higher cIMT measure. Analyses were adjusted for cardiovascular covariates and stratified by age quartiles. RESULTS: All cIMT measures had positive associations with CAC (p＜0.001): [OR, 95% Confidence Interval]: ICAmean [1.23, 1.07-1.42], CCAmean [1.27, 1.08-1.49], Bifmean [1.33, 1.15-1.53], Mean cIMT [1.42, 1.22-1.66], and Mean-Max [1.50, 1.28-1.75]. In age-stratified analyses, only Mean-Max cIMT maintained a significant relationship with CAC in every age quartile (p＜0.05), while CCAmean had some of the weakest associations among age quartiles. CONCLUSIONS: Mean-Max cIMT had consistently stronger associations with coronary calcium, independent of important confounders, such as age. The most oft-used measure, CCAmean, was no longer associated with coronary calcium after age-adjustment and stratification.
AIMS: The utility of carotid intima-media thickness (cIMT) as a marker for coronary heart disease is under heavy debate. This is predominantly due to the lack of a standard definition of cIMT, leading to inconsistent results. We investigated and compared the relationships of five different measures of cIMT with coronary calcium. METHODS: Japanese men aged 40-79y ( n=869) from Shiga Epidemiological Study of Subclinical Atherosclerosis were examined. Mean cIMT was measured in three segments of the carotid arteries: common carotid artery (CCAmean), internal carotid artery (ICAmean) and bifurcation (Bifmean). Mean cIMT of average values (Mean cIMT) and mean cIMT of maximum values (Mean-Max cIMT) of all segments combined were assessed. Coronary calcium was assessed as coronary artery calcification (CAC). Ordinal logistic regression was used to determine the odds ratio (OR) of higher CAC per 1 standard deviation higher cIMT measure. Analyses were adjusted for cardiovascular covariates and stratified by age quartiles. RESULTS: All cIMT measures had positive associations with CAC (p＜0.001): [OR, 95% Confidence Interval]: ICAmean [1.23, 1.07-1.42], CCAmean [1.27, 1.08-1.49], Bifmean [1.33, 1.15-1.53], Mean cIMT [1.42, 1.22-1.66], and Mean-Max [1.50, 1.28-1.75]. In age-stratified analyses, only Mean-Max cIMT maintained a significant relationship with CAC in every age quartile (p＜0.05), while CCAmean had some of the weakest associations among age quartiles. CONCLUSIONS: Mean-Max cIMT had consistently stronger associations with coronary calcium, independent of important confounders, such as age. The most oft-used measure, CCAmean, was no longer associated with coronary calcium after age-adjustment and stratification.
Authors: John R Crouse; Joel S Raichlen; Ward A Riley; Gregory W Evans; Mike K Palmer; Daniel H O'Leary; Diederick E Grobbee; Michiel L Bots Journal: JAMA Date: 2007-03-25 Impact factor: 56.272
Authors: Hester M Den Ruijter; Sanne A E Peters; Todd J Anderson; Annie R Britton; Jacqueline M Dekker; Marinus J Eijkemans; Gunnar Engström; Gregory W Evans; Jacqueline de Graaf; Diederick E Grobbee; Bo Hedblad; Albert Hofman; Suzanne Holewijn; Ai Ikeda; Maryam Kavousi; Kazuo Kitagawa; Akihiko Kitamura; Hendrik Koffijberg; Eva M Lonn; Matthias W Lorenz; Ellisiv B Mathiesen; Giel Nijpels; Shuhei Okazaki; Daniel H O'Leary; Joseph F Polak; Jackie F Price; Christine Robertson; Christopher M Rembold; Maria Rosvall; Tatjana Rundek; Jukka T Salonen; Matthias Sitzer; Coen D A Stehouwer; Jacqueline C Witteman; Karel G Moons; Michiel L Bots Journal: JAMA Date: 2012-08-22 Impact factor: 56.272