Radial artery intima-media thickness predicts major cardiovascular events in patients with suspected coronary artery disease.
OBJECTIVE
In the present study, we investigated the prognostic value of radial artery intima-media thickness (rIMT) in patients with suspected coronary artery disease (CAD). Carotid artery intima-media thickness is a well-known surrogate marker of atherosclerosis. Recently, using very high-resolution ultrasound, we showed rIMT can be imaged with great precision and is related to various cardiovascular risk factors.


RESULTS
We recruited a total of 416 patients (62 ± 9 years, 44% male) with suspected CAD, referred to myocardial perfusion scintigraphy (MPS). Among these patients, 133 underwent coronary angiography on clinical indication. Two-dimensional images of carotid and radial arteries were acquired bilaterally (using 8 and 55 MHz ultrasound, respectively). All patients were followed regarding major adverse cardiovascular events (MACE), including cardiovascular death, myocardial infarction, stroke, and coronary revascularization. A group of 20 healthy subjects (aged 61 ± 3, 50% male) were recruited for reference. During 3 years of follow-up, 77 MACE occurred. Patients with MACE exhibited significantly thicker rIMT vs. those without (0.35 ± 0.06 vs. 0.32 ± 0.07 mm, P < 0.001). Increased rIMT was associated with an increased occurrence of significant coronary artery narrowing, diagnosed by coronary angiography (P = 0.028). Patients with rIMT values above the median had a nearly three-fold increased risk for MACE (hazard ratio 2.8, 95% confidence interval 1.6-4.8). In multivariate analysis, rIMT (P = 0.011) remained a significant predictor of MACE, along with type II diabetes (P = 0.012), body mass index (P = 0.024), and MPS-verified ischaemia (P < 0.001).


CONCLUSIONS
Radial artery IMT, assessed by very high-resolution ultrasound, confers prognostic information in patients with suspected CAD.
Department of Clinical Physiology, Sahlgrenska University Hospital, S-41345 Gothenburg, Sweden Department of Molecular and Clinical Medicine/Clinical Physiology, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, S-41345 Gothenburg, Sweden charlotte.eklund@gu.se.
Charlotte
C
Eklund
Department of Cardiology, Sahlgrenska University Hospital, S-41345 Gothenburg, Sweden.
Elmir
E
Omerovic
Department of Cardiology, Sahlgrenska University Hospital, S-41345 Gothenburg, Sweden.
Inger
I
Haraldsson
Department of Molecular and Clinical Medicine/Clinical Physiology, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, S-41345 Gothenburg, Sweden.
Peter
P
Friberg
Department of Molecular and Clinical Medicine/Clinical Physiology, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, S-41345 Gothenburg, Sweden Translational Sciences, CVGI Innovative Medicine Unit, AstraZeneca R&D, S-43183 Mölndal, Sweden.
Li-Ming
LM
Gan
D054058:Acute Coronary Syndrome / Q000175:diagnosis* / Q000453:epidemiology; D000367:Age Factors; D000368:Aged; D016022:Case-Control Studies; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D055414:Myocardial Perfusion Imaging / Q000379:methods; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D017534:Radial Artery / Q000000981:diagnostic imaging*; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D017539:Tunica Intima / Q000000981:diagnostic imaging* / Q000473:pathology; D017540:Tunica Media / Q000000981:diagnostic imaging* / Q000473:pathology; D018084:Ultrasonography, Interventional
atherosclerosis; cardiovascular disease; intima-media thickness; radial artery; ultrasound