Document Detail

Association between carotid intima-media thickness and aortic arch plaques.
MedLine Citation:
PMID:  20510582     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Large aortic arch plaques are associated with ischemic stroke. Carotid intima-media thickness (CIMT) is a marker of subclinical atherosclerosis and a strong predictor of cardiovascular disease and stroke. The association between CIMT and aortic arch plaques has been studied in patients with strokes, but not in the general population. The aim of this study was to investigate this association in an elderly asymptomatic cohort and to assess the possibility of using CIMT to predict the presence or absence of large aortic arch plaques.
METHODS: Stroke-free control subjects from the Aortic Plaque and Risk of Ischemic Stroke (APRIS) study underwent transesophageal echocardiography and high-resolution B-mode ultrasound of the carotid arteries. CIMT was measured at the common carotid artery, bifurcation, and internal carotid artery. The association between CIMT and aortic arch plaques was analyzed using multivariate regression models. The positive and negative predictive values of CIMT for large (>or=4 mm) aortic arch plaques were calculated.
RESULTS: Among 138 subjects, large aortic arch plaques were present in 35 (25.4%). Only CIMT at the bifurcation was associated with large aortic arch plaques after adjustment for atherosclerotic risk factors (P=.007). The positive and negative predictive values of CIMT for aortic arch plaque>or=4 mm at the bifurcation above the 75th percentile (>or=0.95 mm) were 42% and 80%, respectively. The negative predictive value increased to 87% when the median CIMT value (0.82 mm) was used.
CONCLUSIONS: CIMT at the bifurcation is independently associated with aortic arch plaque>or=4 mm. Its strong negative predictive value for large plaques indicates that CIMT may be used as an initial screening test to exclude severe arch atherosclerosis in the general population.
Elena Tessitore; Tatjana Rundek; Zhezhen Jin; Shunichi Homma; Ralph L Sacco; Marco R Di Tullio
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural     Date:  2010-05-26
Journal Detail:
Title:  Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography     Volume:  23     ISSN:  1097-6795     ISO Abbreviation:  J Am Soc Echocardiogr     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-12     Completed Date:  2010-10-26     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  8801388     Medline TA:  J Am Soc Echocardiogr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  772-7     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2010 American Society of Echocardiography. Published by Mosby, Inc. All rights reserved.
Department of Medicine, Columbia University, New York, New York 10032, USA.
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MeSH Terms
Aged, 80 and over
Aorta, Thoracic / ultrasonography*
Atherosclerosis / etiology*,  ultrasonography
Carotid Arteries / ultrasonography*
Diagnosis, Differential
Disease Progression
Echocardiography, Transesophageal / methods*
Follow-Up Studies
Middle Aged
Predictive Value of Tests
Retrospective Studies
Risk Factors
Severity of Illness Index
Tunica Intima / ultrasonography*
Grant Support

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