title: Increased common carotid artery wall thickness is associated with rapid progression of asymptomatic carotid stenosis.
abstract: OBJECTIVE
  This study aimed to identify clinical and ultrasound imaging predictors of progression of carotid luminal narrowing in subjects with asymptomatic moderate internal carotid artery (ICA) stenosis.
  
  
  METHODS
  A total of 571 subjects with asymptomatic moderate (50-69%) ICA stenoses were enrolled. They underwent ultrasound examination at baseline and after 12 months. Demographics, vascular risk factors, medications, plaque characteristics (surface and echogenicity) and common carotid intima-media thickness (IMT) were collected. At the follow-up examination, any change of ICA stenosis was graded in three categories (i) ≥70% to near occlusion, (ii) near occlusion, and (iii) occlusion. Progression of stenosis was defined as an increase in the stenosis degree by at least one category from baseline to follow-up.
  
  
  RESULTS
  At 12 months, progression occurred in 142 subjects (prevalence rate 25%). At the multivariable logistic model, pathological IMT values (considered as binary variable: normal: ≤1 mm vs. pathologic: >1 mm) significantly predicted the risk for plaque progression after adjusting the model for possible confounders (OR 2.28, 95% CI 1.18-4.43, P = .014, multivariable logistic model).
  
  
  CONCLUSIONS
  Our results confirm the role of carotid wall thickening as a marker of atherosclerosis. Carotid IMT measurement should be considered to implement risk stratification in patients with asymptomatic carotid disease.
authors.forename: Marina
authors.initials: M
authors.lastname: Diomedi
authors.forename: Daria
authors.initials: D
authors.lastname: Scacciatelli
authors.forename: Giulia
authors.initials: G
authors.lastname: Misaggi
authors.forename: Simona
authors.initials: S
authors.lastname: Balestrini
authors.forename: Clotilde
authors.initials: C
authors.lastname: Balucani
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Sallustio
authors.forename: Silvia
authors.initials: S
authors.lastname: Di Legge
authors.forename: Paolo
authors.initials: P
authors.lastname: Stanzione
authors.forename: Mauro
authors.initials: M
authors.lastname: Silvestrini
mesh_terms: D000368:Aged; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging*; D059168:Carotid Intima-Media Thickness / Q000706:statistics & numerical data*; D016893:Carotid Stenosis / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity