COMMON CAROTID INTIMA MEDIA THICKNESS AS AN INDICATOR OF ATHEROSCLEROSIS AT OTHER SITES OF THE CAROTID-ARTERY - THE ROTTERDAM STUDY

To evaluate the association between common carotid intima-media thickn ess and noninvasively assessed atherosclerosis elsewhere in the caroti d artery, we wed data from the Rotterdam Study, a single-center popula tion-based, prospective follow-up study among 7983 subjects aged 55 ye ars or older. Baseline measurements included ultrasonographic evaluati on of the vessel wall characteristics of the carotid arteries, that is , assessment of the presence of atherosclerotic lesions, measurement o f common carotid intima-media thickness, and determination of the pres ence of hemodynamically significant stenosis. The present analysis is based on data obtained from the first 1000 participants. The results w ere adjusted for age and gender. An increase of 1 standard deviation i n common carotid intima-media thickness (0.19 mm) doubled the risk of Plaques in the carotid bifurcation: odds ratio 2.0 (95% confidence int erval (CI): 1.6, 2.4). For hemodynamically significant stenosis of the right internal carotid artery (greater than or equal to 50%), a 1.4 ( 95% CI: 1.0, 2.0) increased risk was found. The risk of atheroscleroti c plaques in the bifurcation in subjects with an intima-media thicknes s above 0.89 mm (upper quintile) relative to those with an intima-medi a thickness below 0.63 mm (lowest quintile) was 6.0 (95% CI: 3.5, 10.2 ). For internal carotid artery stenosis, a relative risk of 2.8 (95% C I 0.5, 15.7) was found. The findings of the present study provide evid ence that increased common carotid intima-media thickness indicates at herosclerosis at other sites of the carotid artery. This study lends s upport to the view that noninvasively assessed increased intima-media thickness of the distal common carotid artery is an indicator of gener alized atherosclerosis.