1. Carotid intima-media thickness as a marker of cardiovascular risk in hypertensive patients with coronary artery disease.
- Author
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Zielinski T, Dzielinska Z, Januszewicz A, Rynkun D, Makowiecka Ciesla M, Tyczynski P, Prejbisz A, Demkow M, Kadziela J, Naruszewicz M, Januszewicz M, Juraszynski Z, Korewicki J, and Ruzyllo W
- Subjects
- Adult, Aged, Aged, 80 and over, Biomarkers, Carotid Arteries diagnostic imaging, Coronary Artery Disease complications, Coronary Artery Disease diagnostic imaging, Coronary Artery Disease mortality, Female, Follow-Up Studies, Humans, Hypertension complications, Hypertension diagnostic imaging, Kaplan-Meier Estimate, Male, Middle Aged, Myocardial Infarction mortality, Predictive Value of Tests, Prognosis, Risk Factors, Stroke mortality, Tunica Intima diagnostic imaging, Tunica Media diagnostic imaging, Ultrasonography, Doppler, Duplex, Carotid Arteries pathology, Coronary Artery Disease diagnosis, Hypertension diagnosis, Tunica Intima pathology, Tunica Media pathology
- Abstract
Background: The aim of this study was to examine the significance of ultrasound-measured carotid intima-media thickness (CIMT) in high-risk patients with hypertension and coronary artery disease (CAD), as an independent prognostic factor in determining the risk of all-cause death or future cardiovascular events., Methods: The study included 297 consecutive patients (mean age +/- SD, 57 +/- 9.4 years) with diagnosed hypertension and CAD, referred for coronary angiography. The mean of maximal CIMT in two arterial segments bilaterally was calculated. The primary endpoint was a patient's death from all causes. Death, stroke, or myocardial infarction comprised the secondary, composite endpoint., Results: There was a follow-up of 1 to 79 (mean, 41) months. The predictors of death in a multivariate Cox proportional hazards model were the number of stenosed coronary arteries (P = .007) and CIMT (P = .001). The risk of the secondary, composite endpoint (death, stroke, or myocardial infarction) was determined by diabetes (P = .008) and CIMT (P = .010). Nearly 99% of patients with "low CIMT" (< or =1.13 mm) survived for 5 years, versus 78% with "high CIMT" >1.13 mm (log-rank test; P < .001). For the secondary, composite endpoint (death, stroke, or myocardial infarction), the event-free survival rate was 95% (low CIMT), versus 74% after 5 years (high CIMT) (P < .008)., Conclusions: Intima-media thickness of the carotid arteries is a strong and independent predictor of death and serious cardiovascular events in hypertensive patients with CAD referred for coronary angiography.
- Published
- 2007
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