Arteriosclerosis, Thrombosis, and Vascular Biology. 2000;20:1622-1629
© 2000 American Heart Association, Inc.
Atherosclerosis and Lipoproteins |
Common Carotid Intima-Media Thickness Predicts Occurrence of Carotid Atherosclerotic Plaques
Longitudinal Results From the Aging Vascular Study (EVA) Study
From the National Institute of Health and Medical Research (INSERM) Unit 258 (M.Z., P.D., D.C.), INSERM Unit 360 (C.B.), Centre de Diagnostic et de Prévention Neurovasculaire (P.-J.T.), Paris; Registre Bourguignon des Cancers Digestifs (C.B.-K.), Dijon; and Centre d’examen EVA-INSERM (C.M.), Nantes, France.
Correspondence to Mahmoud Zureik, MD, PhD, INSERM U 258, Hôpital Paul Brousse, 16 av. Paul Vaillant Couturier, 94807 Villejuif Cedex, France. E-mail zureik{at}vjf.inserm.fr
Abstract—The role of the increase
in the common carotid artery (CCA) intima-media wall thickness (IMT) in
the atherosclerotic process is questionable. This longitudinal study
examined the predictive value of CCA-IMT measured at baseline
examination (at sites free of plaques) on the occurrence of
atherosclerotic plaques in the extracranial carotid arteries during 4
years of follow-up study in a sample of 1010 subjects aged 59 to 71
years. Ultrasound examinations were performed at baseline and 2 years
and 4 years later. The occurrence of carotid plaques during follow-up
was defined as the appearance of 
1 plaque in previously normal
carotid segments and/or the appearance of new plaques in the carotid
segments that previously had plaques. Carotid plaque occurrence was
observed in 185 subjects (18.3%). Age- and sex- adjusted odds ratios
of carotid plaque occurrence were 2.66 (95% CI 1.58 to 4.46,
P<0.001) in subjects having intermediate baseline
CCA-IMT values (quartiles 2 and 3) and 3.67 (CI 2.09 to 6.44,
P<0.001) in those having the highest baseline CCA-IMT
values (quartile 4) compared with those having the lowest baseline
CCA-IMT values (quartile 1). Multivariate adjustment
for major cardiovascular risk factors did not alter the
results. These findings were observed for men and women as well as for
subjects with and without carotid plaques at baseline. This 4-year
longitudinal study shows that CCA-IMT predicts carotid plaque
occurrence in a large sample of relatively old subjects. It extends the
findings obtained from cross-sectional studies and suggests that
increased intima-media thickness might occur in an earlier phase of the
atherosclerotic process.
Key Words: carotid arteries • atherosclerosis • plaque • intima-media thickness • longitudinal studies
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