Carotid atherosclerosis in hypercholesterolemic patients: Relationship with cardiovascular events

Background and Aim: Extracranial cerebrovascular atherosclerosis is a commo n feature of hypercholesterolemia and carotid lesions are goon predictors o f cardiovascular events in the general population. Factors associated with the carotid damage of hypercholesterolemic patients and their relationships with the occurrence of clinical events are investigated in this study. Methods and Results: One hundred and seventeen cardio vascular event-free h ypercholesterolemic subjects underwent a complete clinical examination to l ook for additional risk factors. A blood sample was collected for lipoprote in determination and an ultrasound high resolution B-mode imaging examinati on of the common carotin arteries was performed. Patients were treated acco rding to the current guidelines during a 4-yr follow-up and all major cardi ovascular events were recorded. The prevalence of subjects with increased i ntima-media thickness anti plaque was 21.4% and 29.9% respectively, higher than in normolipidemic controls. Carotin lesions were significantly related to age, hypertension and LDL-cholesterol and HDL-cholesterol levels. The r elative risk of developing a major clinical event was 3.92 (95% CI 1.54-9.9 5, p < 0.004) among categories of carotid status. Ar multivariate analysis, cardiovascular events were independently related to the diagnosis of famil ial hypercolesterolemia (FH), baseline carotid score and mean levels of LDL -cholesterol and HDL-cholesterol during the follow-up. Conclusions: Common risk factors cooperate with plasma lipoprotein levels i n increasing the frequency of carotid lesions of hypercholesterolemic patie nts. Since such lesions are useful predictors of clinical events, B-mode ul trasound evaluation of the carotids should be routinely included in the man agement of these patients. (C) 2001, Medical Press.