title: Short-term progression of maximum intima-media thickness of carotid plaque is associated with future coronary events in patients with coronary artery disease.
abstract: OBJECTIVE
  This study examined whether changes in maximum intima-media thickness of carotid plaque (plaque-IMTmax) over 6 months predict future coronary events in patients with carotid plaque and coronary artery disease (CAD).
  
  
  METHODS
  This study included 240 patients with CAD who had a carotid plaque (IMT ≥ 1.1mm) at entry. A carotid ultrasound examination was performed at entry (1st test) and after 6 months (2nd test). The carotid plaque with the greatest axial thickness at the 1st test was selected as the target plaque for monitoring the change in plaque-IMTmax. After the 2nd test, patients were prospectively followed-up for 3 years or until the occurrence of one of the following coronary events: cardiac death, non-fatal myocardial infarction, or unstable angina pectoris requiring coronary revascularization.
  
  
  RESULTS
  The change in plaque-IMTmax over 6 months ranged from -0.85 to 0.97 mm (mean, -0.006 ± 0.319 mm). There were 41 events during follow-up. In a stepwise multivariate Cox proportional hazards model, the change in plaque-IMTmax was a significant predictor of coronary events after adjustment for known risk factors (HR per 0.1mm increase over 6 months, 1.21; 95%CI, 1.10-1.33, p=0.0001). Analysis of receiver operating characteristic (ROC) curves showed that the addition of the change in plaque-IMTmax to conventional risk factors resulted in a greater area under the ROC curve compared with conventional risk factors alone (0.81 and 0.70, respectively, p=0.02).
  
  
  CONCLUSIONS
  Short-term progression of carotid plaque-IMTmax was associated with future coronary events in patients with CAD.
authors.affiliation: University of Yamanashi, Faculty of Medicine, Department of Internal Medicine ІІ, Shimokato, Chuo, Yamanashi 409-3898, Japan.
authors.forename: Mitsumasa
authors.initials: M
authors.lastname: Hirano
authors.forename: Takamitsu
authors.initials: T
authors.lastname: Nakamura
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Kitta
authors.forename: Isao
authors.initials: I
authors.lastname: Takishima
authors.forename: Juntaro
authors.initials: J
authors.lastname: Deyama
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Daisuke
authors.initials: D
authors.lastname: Fujioka
authors.forename: Yukio
authors.initials: Y
authors.lastname: Saito
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Watanabe
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Watanabe
authors.forename: Ken-ichi
authors.initials: K
authors.lastname: Kawabata
authors.forename: Jyun-ei
authors.initials: JE
authors.lastname: Obata
authors.forename: Kiyotaka
authors.initials: K
authors.lastname: Kugiyama
mesh_terms: D000368:Aged; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000473:pathology*; D003327:Coronary Disease / Q000209:etiology; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging* / Q000473:pathology; D012307:Risk Factors; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000473:pathology*; D017540:Tunica Media / Q000000981:diagnostic imaging / Q000473:pathology*; D014463:Ultrasonography