Distension of the carotid artery and risk of coronary events: the three-city study.
OBJECTIVE
Arterial mechanical properties are of growing interest in the understanding of cardiovascular disease development. We aimed to determine the predictive value of carotid wall mechanics on coronary heart disease (CHD) in the Three-City study.


RESULTS
At baseline, 3337 participants aged > or =65 years underwent a carotid B-mode ultrasonography. During a median follow-up of 43.4 months, 128 CHD occurred. Increased carotid distension (relative stroke change in lumen diameter) was significantly associated with CHD risk. Comparison of subjects in tertile 3 versus those in tertile 1 (reference) showed a hazard ratio (HR) of 1.80 (95% CI, 1.17 to 2.75). Controlling for various confounders including age, heart rate, brachial (or carotid) pulse pressure, and common carotid intima-media thickness did not alter the association between carotid distension and CHD with a HR of 1.79 (95% CI, 1.12 to 2.86; tertile 3 versus tertile 1). Brachial and carotid pulse pressures were also independently associated with CHD. No association was found between CHD and carotid distensibility coefficient, cross-sectional compliance coefficient, Young's elastic modulus, or beta stiffness index.


CONCLUSIONS
In the elderly, increased carotid distension was independently predictive of CHD. This simple and noninvasive parameter might be of particular interest for cardiovascular risk assessment.
Leone
Nathalie
N
INSERM U700, Faculté de Médecine Xavier Bichat, 16 rue Henri Huchard, BP 416, 75018 Paris, France. nathalie.leone@inserm.fr
Ducimetière
Pierre
P
Gariépy
Jerôme
J
Courbon
Dominique
D
Tzourio
Christophe
C
Dartigues
Jean-François
JF
Ritchie
Karen
K
Alpérovitch
Annick
A
Amouyel
Philippe
P
Safar
Michel E
ME
Zureik
Mahmoud
M
D000368:Aged; D001794:Blood Pressure; D001916:Brachial Artery / Q000503:physiopathology; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology*; D002340:Carotid Artery Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D015986:Confounding Factors, Epidemiologic; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D004548:Elasticity; D005260:Female; D005500:Follow-Up Studies; D005602:France; D006801:Humans; D008297:Male; D011159:Population Surveillance; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D014463:Ultrasonography