title: Increased carotid intima-media thickness and plasma homocysteine levels predict cardiovascular and all-cause death: a population-based cohort study.
abstract: BACKGROUND
  There is still debate over the utility of carotid intima-media thickness (C-IMT) or carotid plaque in predicting future cardiovascular events and death. Additionally, the importance of plasma homocysteine levels was raised as a predictor of cardiovascular events and death.
  
  
  METHODS
  1,391 subjects were recruited from the Ansan Geriatric cohort. We used B-mode carotid ultrasonography to assess C-IMT and plaque, measuring average maximal IMT and average mean IMT through 6-8 measurements of far-wall IMT in both common carotid arteries. We evaluated the presence of plaque in carotid segments. Multivariable Cox regression analysis was used to predict both cardiovascular and all-cause mortality.
  
  
  RESULTS
  During a mean follow-up of 62.4 ± 12.4 months, 71 subjects (5.12%) died and 23 (1.66%) died of cardiovascular causes. Multivariable Cox regression analysis found the predictors of cardiovascular mortality to be average maximal IMT (HR = 3.709; 95% CI: 1.202-11.446) and plasma homocysteine (HR = 1.057; 95% CI: 1.012-1.103). All-cause mortality was independently associated with C-IMT (average maximal and average mean IMT) and plasma homocysteine.
  
  
  CONCLUSIONS
  C-IMT and plasma homocysteine levels were found to predict cardiovascular and all-cause mortality independently of the presence of carotid plaque and other cardiovascular risk factors.
authors: Department of Neurology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea.
authors: Jin-Man
authors: JM
authors: Jung
authors: Do Young
authors: DY
authors: Kwon
authors: Changsu
authors: C
authors: Han
authors: Inho
authors: I
authors: Jo
authors: Sangmee Ahn
authors: SA
authors: Jo
authors: Moon Ho
authors: MH
authors: Park
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000097:blood* / Q000401:mortality* / Q000473:pathology*; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D059168:Carotid Intima-Media Thickness; D002423:Cause of Death; D015331:Cohort Studies; D005260:Female; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D008297:Male; D016016:Proportional Hazards Models; D012307:Risk Factors
chemical_list: D006710:Homocysteine