Jl. Megnien et al., PRECLINICAL CHANGES OF EXTRACORONARY ARTERIAL STRUCTURES AS INDICATORS OF CORONARY ATHEROSCLEROSIS IN MEN, Journal of hypertension, 16(2), 1998, pp. 157-163
Background Carotid artery structure change was associated with coronar
y artery stenosis by angiography of subjects who were for the most par
t symptomatic. Objective To determine whether structural changes at mu
ltiple extracoronary sites were associated with noninvasively detected
coronary calcium for 94 asymptomatic high-risk men. Methods and resul
ts B-mode ultrasonography allowed us to detect plaque at three sites (
carotid, femoral, and abdominal aorta) and to measure intima-medial th
ickness both in common carotid and in femoral arteries. Ultrafast comp
uted tomography determined the presence and amount of coronary calcifi
cation. After adjustment for age, plaques at two or three sites were a
ssociated with extensive amounts of coronary calcium [odds ratio 4.94
(95% confidence interval 1.08-23)], but not with the presence of coron
ary calcium; increase in carotid intima-medial thickness was not assoc
iated with presence and extent of coronary calcium; and increase in fe
moral intima-medial thickness was associated with presence of coronary
calcium [odds ratio 1.44 (95% confidence interval 1.03-2)] and extens
ive coronary calcium [odds ratio 1.50 (95% confidence interval 0.97-2.
33)]. Adjustment for cardiovascular risk factors attenuated these asso
ciations.Conclusions Femoral intima-medial thickness predicted presenc
e of coronary calcium whereas femoral intima-medial thickness and over
all multiple plaques predicted extensive coronary calcium. Because cor
onary calcium is a marker of atherosclerosis and a predictor of corona
ry events, B-mode ultrasonography could be of clinical value for strat
ifying coronary risk (C) 1998 Rapid Science Ltd.