title: Common carotid intima-media thickness as a risk factor for outcomes in Asian patients with acute ST-elevation myocardial infarction.
abstract: BACKGROUND
  Carotid intima-media thickness (CIMT) is associated with an increased risk of cardiovascular disease. We studied whether CIMT predicts the prognosis of Asian patients with acute ST-elevation myocardial infarction (STEMI).
  
  
  METHODS
  A total of 345 patients with STEMI (men, 82.9%; age, 59 ± 13 years) treated with emergent revascularization were prospectively investigated. In all patients, common CIMT was measured with high-resolution ultrasonography. The patients were followed for a median period of 583 days, and the primary end point was major adverse cardiovascular events (MACE) defined as a composite of cardiovascular death, heart failure, nonfatal recurrent MI, revascularization, and stroke.
  
  
  RESULTS
  Mean CIMT of the patients with STEMI was 0.77 ± 0.14 mm. Of the total patients, 20.6% had carotid plaque and 11.0% experienced MACE. Killip class, left ventricular (LV) function, and carotid plaque were associated with 30-day MACE, whereas CIMT and carotid plaque were related to overall MACE. After adjusting for age, the event rate was 19.0% in the third-tertile CIMT (≥ 0.83 mm) group, 12.1% in the second-tertile (0.70-0.82 mm) group, and 4.3% in the first-tertile (≤ 0.69 mm) group (P = 0.01). Carotid plaque was independently associated with a higher incidence of MACE (adjusted odds ratio [OR], 3.7; 95% confidence interval [CI], 1.327-10.234; P = 0.012). Area under the receiver operating characteristic (ROC) curve for CIMT tertile (0.69 ± 0.05) was significantly larger compared with those for door-to-balloon time (0.55 ± 0.05), LV ejection fraction (LVEF) (0.49 ± 0.05), and Killip class (0.48 ± 0.05) (P < 0.001).
  
  
  CONCLUSIONS
  CIMT was a useful prognosticator to predict future cardiovascular events (CVEs) in Asian patients with STEMI.
authors.affiliation: Cardiovascular Center, Seoul National University Hospital, Republic of Korea.
authors.forename: Sahmin
authors.initials: S
authors.lastname: Lee
authors.affiliation: Seoul National University Bundang Hospital, Republic of Korea. Electronic address: cardioch@snu.ac.kr.
authors.forename: Goo-Yeong
authors.initials: GY
authors.lastname: Cho
authors.affiliation: Hallym University Medical Center, Republic of Korea.
authors.forename: Hyun-Sook
authors.initials: HS
authors.lastname: Kim
authors.affiliation: Seoul National University Bundang Hospital, Republic of Korea.
authors.forename: Yeonyee E
authors.initials: YE
authors.lastname: Yoon
authors.affiliation: Cardiovascular Center, Seoul National University Hospital, Republic of Korea.
authors.forename: Seung-Pyo
authors.initials: SP
authors.lastname: Lee
authors.affiliation: Cardiovascular Center, Seoul National University Hospital, Republic of Korea.
authors.forename: Hyung-Kwan
authors.initials: HK
authors.lastname: Kim
authors.affiliation: Cardiovascular Center, Seoul National University Hospital, Republic of Korea.
authors.forename: Yong-Jin
authors.initials: YJ
authors.lastname: Kim
authors.affiliation: Cardiovascular Center, Seoul National University Hospital, Republic of Korea.
authors.forename: Dae-Won
authors.initials: DW
authors.lastname: Sohn
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002339:Carotid Arteries / Q000000981:diagnostic imaging*; D059168:Carotid Intima-Media Thickness; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy; D062645:Percutaneous Coronary Intervention; D011379:Prognosis; D011446:Prospective Studies; D056910:Republic of Korea / Q000453:epidemiology; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends