title: Diagnostic value of carotid intima-media thickness in indicating multi-level atherosclerosis.
abstract: Carotid intima-media thickness (CIMT) is an indicator of atherosclerosis, but its association with multi-level involvement is sparsely investigated. Study aimed to examine interrelation between CIMT and number of arterial territories with significant (>50%) stenoses, including coronary, supraaortic, renal and iliac/femoral arteries.
  
  
  RESULTS
  Study formed 415 patients (294 men), aged 62.9+/-9.3 years referred to coronary angiography. CIMT assessment was performed in common, bulb and internal carotid segments, and expressed as the mean aggregate value. In all patients, both coronary, renal angiography and supraaortic, iliac/femoral arteries ultrasound was performed. Group I formed 102 patients without significant lesions in any of investigated territories; group II formed 131 patients with single territory; group III formed 102 patients with two territory and group IV formed 80 patients with three to four territory involvements. CIMT correlated with increasing number of involved territories (r=0.751, p<0.001). Aggregate CIMT, previous myocardial infarction, creatinine level, hypertension, hs-CRP, smoking were independent predictors of multi-level involvement (p<0.001, R=0.768). ROC curves showed that CIMT cut-off value of 1.308 mm could distinguish 0-1 from two to three level involvement with sensitivity of 81.6%, specificity 88.8%, PPV 85.1%, NPV 86.3% (odds ratio 35.9, range 20-65).
  
  
  CONCLUSIONS
  CIMT increases with number of involved territories. CIMT is an independent predictor of significant multi-level atherosclerosis, showing high sensitivity and specificity for indicating more advanced territorial atherosclerotic involvement.
authors.affiliation: Department of Cardiac and Vascular Diseases, Institute of Cardiology, Collegium Medicum Jagiellonian University, School of Medicine, 31-202 Krakow, Poland. kablakziembicka@op.pl
authors.forename: Anna
authors.initials: A
authors.lastname: Kablak-Ziembicka
authors.forename: Tadeusz
authors.initials: T
authors.lastname: Przewlocki
authors.forename: Wieslawa
authors.initials: W
authors.lastname: Tracz
authors.forename: Piotr
authors.initials: P
authors.lastname: Pieniazek
authors.forename: Piotr
authors.initials: P
authors.lastname: Musialek
authors.forename: Ireneusz
authors.initials: I
authors.lastname: Stopa
authors.forename: Jaroslaw
authors.initials: J
authors.lastname: Zalewski
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Zmudka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D050197:Atherosclerosis / Q000175:diagnosis* / Q000000981:diagnostic imaging; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D017539:Tunica Intima / Q000648:ultrastructure; D017540:Tunica Media / Q000000981:diagnostic imaging; D014463:Ultrasonography