title: Carotid intima-media thickness in pre- and postmenopausal women with suspected coronary artery disease.
abstract: Carotid intima-media thickness (CIMT) is an early marker of coronary artery disease (CAD). This study aimed to evaluate CIMT value for CAD prediction in pre-and postmenopausal women referred for coronary angiography with angina-like symptoms and a positive result of the treadmill test. The study comprised 321 women referred for coronary angiography with symptoms suggesting CAD. Carotid intima-media thickness was measured in common, bifurcation, and internal carotid artery, and expressed as the mean maximum value. Coronary angiography showed coronary stenosis > or = 50% in 211 (65.7%) women, including 27 with regular menses (47.3 +/- 3.4 years) and 184 postmenopausal (65.8 +/- 7.2 years). Normal coronary arteries were found in 110 women: 17 (47.3 +/- 4.9 years) with regular menses and 93 postmenopausal (64.3 +/- 6.5 years). The highest CIMT values were found in postmenopausal CAD women (1.360 +/- 0.32 mm), as compared to premenopausal with CAD (1.178 +/- 0.36 mm, P = 0.005), pre- (0.860 +/- 0.23 mm, P < 0.001) and postmenopausal (1.022 +/- 0.30 mm, P < 0.001) women without CAD. Carotid intima-media thickness (P < 0.001), hyperlipidemia (P = 0.018), and myocardial infarction (P < 0.001), but not menopause itself or the number of years since menses cessation, were found to be independent CAD predictors. By receiver operating characteristic calculation, the mean maximum CIMT cut-off values discriminating CAD were lower in premenopausal (> or = 0.933 mm) than in postmenopausal women (> or = 1.075 mm; P < 0.05) resulting in similar sensitivity (85.2% and 82.6%) and specificity (70.6% and 69.9%). Carotid intima-media thickness is a strong CAD predictor in both pre- and postmenopausal women, in contrast to the menopausal status.
authors.affiliation: Department of Cardiac and Vascular Diseases, Institute of Cardiology, Collegium Medicum, Jagiellonian University, 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: Andrzej
authors.initials: A
authors.lastname: Sokolowski
authors.forename: Rafal
authors.initials: R
authors.lastname: Drwila
authors.forename: Daniel
authors.initials: D
authors.lastname: Rzeznik
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002339:Carotid Arteries / Q000000981:diagnostic imaging*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis*; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006984:Hypertrophy / Q000000981:diagnostic imaging; D008875:Middle Aged; D017698:Postmenopause / Q000502:physiology*; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D017539:Tunica Intima / Q000000981:diagnostic imaging*; D014463:Ultrasonography