Survival from cardiovascular events as predicated by carotid (common carotid artery) intima-media thickness and Doppler values in ischaemic Chinese patients requiring coronary angiogrm

Abstract

INTRODUCTION: Carotid intima-media thickness (cIMT) of the common carotid artery may be correlated to the presence of coronary artery disease. However, the role of the cIMT and Doppler findings in predicting subsequent cardiovascular events has not been established. The aim of this study was to investigate the predictive value. METHODS: A total of 212 consecutive Chinese patients undergoing clinically driven coronary angiogram were evaluated. Carotid parameters (cIMT, peak systolic velocity [PSV] and end diastolic velocity, at the bulb, internal and common carotid artery, on both sides) were analysed using the IE33 auto-detection program. Patients were followed up and monitored for the occurrence of the primary composite end-point (PCEP), defined as all cardiovascular deaths, non-fatal MI, stroke, CHF, ACS or arrhythmias requiring hospitalisation or intervention. RESULTS: To date, the mean follow-up time was 534±234 days. The PCEP was reached in 25 subjects (11.8%). The right common cIMT was shown to be a predictor for critical coronary stenosis requiring PCI (area under ROC curve=0.626, P=0.001). cIMT <0.8 mm was associated with a better survival (log rank test, P=0.029). Univariate analysis, a right common cIMT of ≥0.8mm, the right common carotid PSV, and the waist circumference were independent predictors for the PCEP. Cox proportional hazards model adjusted for age showed the right common carotid PSV was the only independent predictor for the PCEP (HR=0.963; 95% CI, 0.939-0.987, P=0.002). Similar correlations were not observed with the overall (left and right) cIMT or the left cIMT in this study. CONCLUSION: The right common carotid PSV and the right common cIMT ≥0.8 mm are shown to predict the cardiovascular survival in this study. The latter also strongly correlates with the presence of critical coronary stenosis requiring intervention.