title: Aneurysmal disease is associated with lower carotid intima-media thickness than occlusive arterial disease.
abstract: OBJECTIVE
  Patients with aneurysmal and occlusive arterial disease have overlapping cardiovascular risk profiles. The question remains how atherosclerosis is related to the formation of aortic aneurysms. Common carotid artery intima-media thickness (CIMT) is an easily accessible and objective marker of early atherosclerosis. The aim of the current study was to investigate whether there is a difference in atherosclerotic burden as measured by CIMT between patients with aneurysmal and those with occlusive arterial disease.
  
  
  METHODS
  From 2004 to 2011, the CIMT was measured using B-mode ultrasound scanning in patients undergoing vascular surgery for aortic aneurysmal or occlusive arterial disease at the Erasmus University Medical Center. Cardiovascular risk factors, comorbidities, and medication were recorded. Patients treated for combined aneurysmal and occlusive arterial disease and patients diagnosed with a genetic aneurysm syndrome were excluded. Univariable and multivariable analyses were used to calculate differences in CIMT between aneurysmal and occlusive arterial disease.
  
  
  RESULTS
  In total, 904 patients were included in the study: 502 patients with aneurysmal disease (85% male; mean age, 72 years) and 402 patients with occlusive arterial disease (65% male; mean age, 64 years). The mean (standard deviation) CIMT in patients with aneurysmal disease was 0.97 (0.29) mm and was 1.07 (0.38) mm in patients with occlusive arterial disease (P < .001). Adjustment for cardiovascular risk factors, comorbidities, and medication showed a mean difference in CIMT of 0.15 mm (95% confidence interval, 0.10-0.20; P < .001).
  
  
  CONCLUSIONS
  The current study shows a lower CIMT in patients with aneurysmal disease than in those with occlusive arterial disease, indicating a lower atherosclerotic burden in patients with aneurysmal disease. These findings endorse the idea that additional pathogenic mechanisms are involved in aortic aneurysm formation. Further studies are needed to clarify the role of atherosclerosis in aortic aneurysm formation.
authors.affiliation: Department of Vascular Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Koen M
authors.initials: KM
authors.lastname: van de Luijtgaarden
authors.forename: Erik J
authors.initials: EJ
authors.lastname: Bakker
authors.forename: Ellen V
authors.initials: EV
authors.lastname: Rouwet
authors.forename: Sanne E
authors.initials: SE
authors.lastname: Hoeks
authors.forename: Tabita M
authors.initials: TM
authors.lastname: Valentijn
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Stolker
authors.forename: Danielle
authors.initials: D
authors.lastname: Majoor-Krakauer
authors.forename: Hence J M
authors.initials: HJ
authors.lastname: Verhagen
mesh_terms: D000368:Aged; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging / Q000473:pathology*; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000473:pathology*; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000473:pathology*; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000473:pathology*; D059168:Carotid Intima-Media Thickness; D016009:Chi-Square Distribution; D015897:Comorbidity; D005260:Female; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009426:Netherlands; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors