PRECLINICAL CHANGES OF EXTRACORONARY ARTERIAL STRUCTURES AS INDICATORS OF CORONARY ATHEROSCLEROSIS IN MEN

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.