B-mode ultrasound common carotid artery intima-media thickness and external diameter: cross-sectional and longitudinal associations with carotid atherosclerosis in a large population sample

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  • Eigenbrodt, Marsha L
    • Other Affiliation: Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA
  • Bursac, Zoran
    • Other Affiliation: Department of Biostatistics, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA
  • Tracy, Richard E
    • Other Affiliation: Department of Pathology, Louisiana State University Health Science Center, New Orleans, LA, USA
  • Mehta, Jawahar L
    • Other Affiliation: Department of Internal Medicine, Department of Physiology, Department of Biophysics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
  • Rose, Kathryn M.
    • Affiliation: Gillings School of Global Public Health, Department of Epidemiology
  • Couper, David
    • Affiliation: Gillings School of Global Public Health, Department of Biostatistics
Abstract
  • Abstract: Background: Arterial diameter and intima-media thickness (IMT) enlargement may each be related to the atherosclerotic process. Their separate or combined enlargement may indicate different arterial phenotypes with different atherosclerosis risk. Methods: We investigated cross-sectional (baseline 1987–89: n = 7956) and prospective (median follow-up = 5.9 years: n = 4845) associations between baseline right common carotid artery (RCCA) external diameter and IMT with existing and incident carotid atherosclerotic lesions detected by B-mode ultrasound in any right or left carotid segments. Logistic regression models (unadjusted, adjusted for IMT, or adjusted for IMT and risk factors) were used to relate baseline diameter to existing carotid lesions while comparably adjusted parametric survival models assessed baseline diameter associations with carotid atherosclerosis progression (incident carotid lesions). Four baseline arterial phenotypes were categorized as having 1) neither IMT nor diameter enlarged (reference), 2) isolated IMT thickening, 3) isolated diameter enlargement, and 4) enlargement of both IMT and diameter. The association between these phenotypes and progression to definitive carotid atherosclerotic lesions was assessed over the follow-up period. Results: Each standard deviation increment of baseline RCCA diameter was associated with increasing carotid lesion prevalence (unadjusted odds ratio [OR] = 1.54, 95% confidence interval [CI] = 1.47–1.62) and with progression of carotid atherosclerosis (unadjusted hazards ratio (HR) = 1.37, 95% CI = 1.28–1.46); and the associations remained significant even after adjustment for IMT and risk factors (prevalence OR = 1.11, 95% CI = 1.04–1.18; progression HR = 1.11, 95% CI = 1.03–1.19). Controlling for gender, age and race, persons with both RCCA IMT and diameter in the upper 50th percentiles had the greatest risk of progressing to clearly defined carotid atherosclerotic lesions (all HR = 1.71, 95% CI = 1.47–2.0; men HR = 1.88, 95% CI = 1.48– 2.39; women HR = 1.59, 95% CI = 1.31–1.95) while RCCA IMT or diameter alone in the upper 50th percentile produced significantly lower estimated risks. Conclusion: RCCA IMT and external diameter provide partially overlapping information relating to carotid atherosclerotic lesions. More importantly, the RCCA phenotype of coexistent wall thickening with external diameter enlargement indicates higher atherosclerotic risk than isolated wall thickening or diameter enlargement.
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  • Article
Rights statement
  • In Copyright
Rights holder
  • Marsha L Eigenbrodt et al.; licensee BioMed Central Ltd.
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Journal title
  • Cardiovascular Ultrasound
Journal volume
  • 6
Journal issue
  • 1
Page start
  • 10
Language
  • English
Is the article or chapter peer-reviewed?
  • Yes
ISSN
  • 1476-7120
Bibliographic citation
  • Cardiovascular Ultrasound. 2008 Mar 05;6(1):10
Publisher
  • BioMed Central Ltd
Access right
  • Open Access
Date uploaded
  • August 24, 2012

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