scholarly journals Carotid Intima‐Media Thickness and the Risk of Sudden Cardiac Death: The ARIC Study and the CHS

2020 ◽  
Vol 9 (19) ◽  
Author(s):  
Takeki Suzuki ◽  
Wanmei Wang ◽  
Anthony Wilsdon ◽  
Kenneth R. Butler ◽  
Selcuk Adabag ◽  
...  
Keyword(s):  
Sudden Cardiac Death ◽  
Carotid Artery ◽  
Common Carotid Artery ◽  
Cardiac Death ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Cardiovascular Health Study ◽  
Media Thickness ◽  
Increased Risk ◽  
Aric Study

Background Sudden cardiac death (SCD) is associated with severe coronary heart disease in the great majority of cases. Whether carotid intima‐media thickness (C‐IMT), a known surrogate marker of subclinical atherosclerosis, is associated with risk of SCD in a general population remains unknown. The objective of this study was to investigate the association between C‐IMT and risk of SCD. Methods and Results We examined a total of 20 862 participants: 15 307 participants of the ARIC (Atherosclerosis Risk in Communities) study and 5555 participants of the CHS (Cardiovascular Health Study). C‐IMT and common carotid artery intima‐media thickness was measured at baseline by ultrasound. Presence of plaque was judged by trained readers. Over a median of 23.5 years of follow‐up, 569 participants had SCD (1.81 cases per 1000 person‐years) in the ARIC study. Mean C‐IMT and common carotid artery intima‐media thickness were associated with risk of SCD after adjustment for traditional risk factors and time‐varying adjustors: hazard ratios (HRs) with 95% CIs for fourth versus first quartile were 1.64 (1.15–2.63) and 1.49 (1.05–2.11), respectively. In CHS, 302 participants developed SCD (4.64 cases per 1000 person‐years) over 13.1 years. Maximum C‐IMT was associated with risk of SCD after adjustment: HR (95% CI) for fourth versus first quartile was 1.75 (1.22–2.51). Presence of plaque was associated with 35% increased risk of SCD: HR (95% CI) of 1.37 (1.13–1.67) in the ARIC study and 1.32 (1.04–1.68) in CHS. Conclusions C‐IMT was associated with risk of SCD in 2 biracial community‐based cohorts. C‐IMT may be used as a marker of SCD risk and potentially to initiate early therapeutic interventions to mitigate the risk.

The evaluation of carotid intima-media thickness in children with beta-thalassaemia major

2011 ◽  
Vol 22 (1) ◽  
pp. 79-83 ◽  
Author(s):  
Mustafa Dogan ◽  
Elvan Caglar Citak
Keyword(s):  
Carotid Artery ◽  
Common Carotid Artery ◽  
Disease Duration ◽  
Intima Media Thickness ◽  
P Value ◽  
Healthy Children ◽  
Thalassaemia Major ◽  
Beta Thalassaemia ◽  
Media Thickness ◽  
Increased Risk

AbstractBackgroundCardiovascular complications and vascular changes are common in patients with beta-thalassaemia major. The aim of this study is to investigate the common carotid artery intima-media thickness in children.MethodsThe study population was consisted of 33 thalassaemic children (22 boys and 11 girls, with a median age of 8 years) and 30 healthy children for control (12 girls and 18 boys, with a median age of 8 years) who were matched for age and gender. Common carotid artery intima-media thickness of the children was measured.ResultsThe patients’ age at diagnosis ranged from 0.25 to 2 years, with a median of 0.6 months. Their disease duration ranged from 4 to 13.75 years, with a median of 6.5 years. The patients’ median common carotid artery intima-media thickness was significantly higher than controls – that is, 0.87 versus 0.74, with a p-value less than 0.005. The mean common carotid artery intima-media thickness value was positively correlated with disease duration (r = 0.535), with a p-value less than 0.01 and ferritin level (r = 0.501), with a p-value less than 0.01.ConclusionOwing to the nature of the disease, patients with beta-thalassaemia major should be considered to have an increased risk of early vascular alteration and atherosclerosis. For this reason, common carotid artery intima-media thickness measurement can be recommended as a non-invasive and early diagnostic method.

scholarly journals Carotid Intima-Media Thickness in Patients with Subclinical Hypothyroidism: A Prospective Controlled Study

2021 ◽  
Vol 44 (4) ◽  
pp. E39-45
Author(s):  
Anally J. Soto-García ◽  
Guillermo Elizondo-Riojas ◽  
Rene Rodriguez-Gutiérrez ◽  
Leonardo G. Mancillas-Adame ◽  
J. Gerardo González-González
Keyword(s):  
Cardiovascular Risk ◽  
Carotid Artery ◽  
Subclinical Hypothyroidism ◽  
Common Carotid Artery ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Controlled Study ◽  
Overt Hypothyroidism ◽  
Media Thickness

Purpose: The association between subclinical hypothyroidism (SCH) and cardiovascular risk, particularly with a TSH <10 µIU/ml, remains controversial. The objective of our study was to assess the association between SCH and cardiovascular risk through carotid intima-media thickness, and alternatively, to evaluate its change after treatment with levothyroxine. Methods: A total of 54 individuals were included in the study: 18 with SCH; 18 with overt hypothyroidism (OH); and 18 healthy controls (HC). The carotid intima-media thickness was measured in each group. In SCH, follow-up was performed at three and six months after the start of levothyroxine treatment. Results: The mean age of the total population at baseline was 35.8 years. The median TSH in SCH was 6.15 µIU/ml. The carotid intima-media thickness (mean and standard deviation) was greater in SCH in comparison to the HC group: right common carotid artery (RCCA), 0.486 ± 0.106 mm and 0.413 ± 0.075 mm in SCH and HC, respectively, p=0.01 and left common carotid artery (LCCA), 0.511 ± 0.144 mm and 0.427 mm ± 0.090 in SCH and HC, respectively, p=0.03). In patients with SCH, there was a decrease in the carotid intima-media thickness after treatment with levothyroxine (RCCA and LCCA, p <0.05 at three and six months). Conclusions: There was an association between increased carotid intima-media thickness in patients with SCH in comparison with HC, even with a TSH <10 µIU/ml. The increase was reversed with levothyroxine therapy. The association of this increased thickness with important cardiovascular outcomes remains uncertain and should be evaluated in future studies.

scholarly journals Evaluation of atherosclerosis in patients with chronic kidney disease by measuring carotid intima media thickness: An observational study from a tertiary care center in India

2021 ◽  
Vol 12 (12) ◽  
pp. 50-57
Author(s):  
Lamsaka Lyngdoh ◽  
Bodhibrata Banerjee ◽  
Sampurna Chowdhury ◽  
Rishav Mukherjee ◽  
Subhendu Bikash Naiya ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Carotid Artery ◽  
Cardiovascular Mortality ◽  
Common Carotid Artery ◽  
Serum Triglyceride ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Media Thickness ◽  
Atherosclerotic Burden

Background: Chronic kidney disease (CKD) is associated with a substantial cardiovascular mortality and morbidity. Besides other factors, accelerated atherosclerosis plays a significant role in this. Carotid intima media thickness (CIMT) is an index of systemic atherosclerosis. By measuring the CIMT with the help of B mode ultrasound at common carotid artery, the overall atherosclerotic burden in CKD patients can be estimated. Accordingly patients at increased risk of premature mortality can be identified so that timely intervention can be taken. Aims and Objectives: The aim of the study was to measure the CIMT at the level of common carotid artery by B mode ultrasound for estimation of atherosclerotic burden in patients with CKD. Materials and Methods: It is a hospital based observational cross-sectional study involving 70 patients carried out in the department of General Medicine of Medical College and Hospital, Kolkata for a period of 1 year. Patients were selected on the basis of certain inclusion and exclusion criteria. They were evaluated based on clinical history, disease duration, physical examination findings and certain investigation parameters such as complete hemogram, renal function tests, serum potassium, lipid profile, urinalysis, urine for albumin-creatinine ratio, ultrasonography of kidney-ureter-bladder, and CIMT value as measured by B mode ultrasound of carotid artery. The data collected were analyzed with a suitable statistical analysis software package. Range, frequencies, percentage, mean, standard deviation, and P value were calculated. P<0.05 was taken as significant. Results: The study showed a strong correlation between CIMT and BMI (r=0.533, P<0.001). CIMT for serum triglyceride levels (≥150 mg/dl) were significantly (P<0.001) high in patients (mean±SD=1.45±0.559) mg/dl in comparison with serum triglyceride levels (<150 mg/dl) (0.98 ± 0.380 mg/d). Patients with high cholesterol of ≥200 mg/dl have a higher CIMT of 1.56±0.574 with P<0.001. There is statistically significant relation of LDL with respect to mean CIMT as P<0.001 at 1% level of significance. Hence, mean CIMT is more in LDL (≥130) than in LDL (<130). CIMT for HDL levels (<40 mg/dl) were high in CKD (mean=1.53±0.518 mg/dl) patients compared to HDL levels (≥40 mg/dl) (mean=10.88±0.291). It was found that mean CIMT was higher in the later stages of kidney disease (Stage 3B, 4 and Stage 5) as compared to early stages (Stages 1, 2, and 3). We also found that the Mean CIMT (1.214±0.531 was higher in patients with CKD compared to sonographically defined normal value (<0.9 mm). Hence, CKD patients who have traditional risk factors for atherosclerosis such as higher BMI, higher serum total cholesterol level, higher serum triglyceride level, higher serum LDL level, and lower serum HDL level have a higher value of CIMT. Conclusion: B-mode ultrasound is a non-invasive sensitive tool for assessment of CIMT. Since CKD is associated with accelerated atherosclerosis and subsequent increased cardiovascular mortality, this modality may help us to identify patients with atherosclerotic burden so that timely intervention can be taken to reduce future cardiovascular complications in CKD patients.

scholarly journals Carotid intima-media thickness in patients with subclinical hypothyroidism: A prospective controlled study

2020 ◽  
Author(s):  
Anally Soto-García ◽  
Guillermo Elizondo-Riojas ◽  
Rene Rodriguez-Gutiérrez ◽  
Leonardo Mancillas-Adame ◽  
Jose Gerardo Gonzalez-Gonzalez
Keyword(s):  
Cardiovascular Risk ◽  
Carotid Artery ◽  
Subclinical Hypothyroidism ◽  
Common Carotid Artery ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Controlled Study ◽  
Overt Hypothyroidism ◽  
Media Thickness

Background: The association between subclinical hypothyroidism (SCH) and cardiovascular risk, particularly with a TSH <10µIU/ml, remains controversial. The objective of our study was to assess the association between SCH and cardiovascular risk through carotid intima-media thickness, and alternatively, to evaluate its change after treatment with levothyroxine. Methods: A total of 54 individuals were included in the study, 18 with SCH, 18 with overt hypothyroidism (OH), and 18 healthy controls (HC). The carotid intima-media thickness was measured in each group. In SCH, follow-up was performed at three and six months after the start of levothyroxine. Results: The mean age of the total population at baseline was 35.8 years. The median TSH in SCH was 6.15 µIU/ml. The carotid intima-media thickness was greater in SCH in comparison to the HC group (Right common carotid artery [RCCA, mm]: 0.486 ± 0.106 and 0.413 ± 0.075 in SCH and HC, respectively, p=0.01. Left common carotid artery [LCCA, mm]: 0.511±0.144 and 0.427±0.090 in SCH and HC, respectively, p=0.03). In patients with SCH, there was a decrease in the carotid intima-media thickness after treatment with levothyroxine (RCCA and LCCA p <0.05 at 3 and 6 months). Conclusions: There is an association between an increase in the carotid intima-media thickness in patients with SCH in comparison to HC, even with a TSH <10 µIU/ml. The increase reversed with levothyroxine therapy. Its association with important cardiovascular outcomes remains uncertain and should be evaluated in future studies.

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