Document Detail

Carotid and peripheral atherosclerosis in patients who underwent primary percutaneous coronary intervention and outcome associated with multifocal atherosclerosis.
MedLine Citation:
PMID:  17164746     Owner:  NLM     Status:  MEDLINE    
AIM: The aim of our study was to determine if patients with multifocal atherosclerosis have a worse prognosis than patients with atherosclerosis only in the coronary bed. METHODS: We studied 45 subjects admitted to intensive coronary care unit of the Division of Cardiology with the diagnosis of acute myocardial infarction (AMI). Traditional cardiovascular risk factors were investigated and laboratory analysis included measurement of plasma lipids, glycemia, fibrinogen and high-sensitivity-C-reactive protein (hs-CRP). Each patient underwent coronary-angiography as well as carotid and peripheral arterial ultrasound examination. A follow-up of 13+/-2 months was performed. RESULTS: We found that the severity of coronary atherosclerosis is significantly associated with the presence of carotid (P<0.05) and peripheral atherosclerosis (P<0.005). Markers of inflammation, hs-CRP (P<0.005) and fibrinogen (P<0.05), were significantly associated with multifocal atherosclerosis. We have shown that an increased number of coronary vessels with atherosclerotic stenosis is associated with a higher value of carotid (P<0.0001) and peripheral intima media thickness (P<0.0001). During 13 months of follow-up the incidence of fatal or non fatal events was 18%. The multivariate analysis showed that the variables independently associated with fatal and non fatal events were: male sex (P<0.001), family history of cardiovascular disease (P<0.005), hypertension (P<0.01), diabetes mellitus (P<0.05), higher levels of total cholesterol (P<0.05), smoking habit (P<0.05), and multifocal atherosclerosis (P<0.05). CONCLUSIONS: The ultrasound examination of carotid and peripheral atherosclerotic lesions may be useful in placing patients with AMI in a category of higher risk of cerebrovascular and cardiovascular events. Moreover, the precocious identification of patients at risk can suggest a more aggressive pharmacological treatment and a more accurate follow-up in order to avoid future events.
G Romano; E Corrado; I Muratori; G Novo; G Andolina; V Cospite; S Evola; G F Ciaramitaro; A Di Vincenzo; M Farinella; A Rotolo; P Assennato; E Hoffmann; S Novo
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  International angiology : a journal of the International Union of Angiology     Volume:  25     ISSN:  0392-9590     ISO Abbreviation:  Int Angiol     Publication Date:  2006 Dec 
Date Detail:
Created Date:  2006-12-13     Completed Date:  2007-06-21     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8402693     Medline TA:  Int Angiol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  389-94     Citation Subset:  IM    
Section of Cardiovascular Diseases, Post-graduate School of Cardiology, Department of Internal Medicine, Cardiovascular and Nephro-Urological Diseases, University Hospital "P. Giaccone" of Palermo, 90127 Palmero, Italy.
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MeSH Terms
Angioplasty, Transluminal, Percutaneous Coronary*
Atherosclerosis / complications*
Carotid Artery Diseases / complications*
Coronary Artery Disease / complications
Follow-Up Studies
Middle Aged
Myocardial Infarction / complications*,  surgery*
Risk Factors
Treatment Outcome

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