title: Relationship between carotid intima-media thickness and non valvular atrial fibrillation type.
abstract: OBJECTIVE
  Carotid intima-media thickness (cIMT) is a surrogate marker of subclinical atherosclerosis and it is able to predict both coronary and cerebral vascular events. No data exist on the association between cIMT and non valvular atrial fibrillation (NVAF) type. We conduct this study with the aim to analyze the association between abnormal cIMT and NVAF type.
  
  
  METHODS
  A cross-sectional study of the "Atrial fibrillation Registry for Ankle-brachial index Prevalence Assessment-Collaborative Italian Study (ARAPACIS)" has been performed. Among 2027 patients enrolled in the ARAPACIS, 673 patients, who underwent carotid ultrasound examination to assess cIMT, were included in the study.
  
  
  RESULTS
  Among the entire population, 478 patients (71%) had cIMT > 0.90 mm. Patients with an abnormal cIMT (>0.90 mm) were significantly older and more likely hypertensive, diabetic and with a previous history of stroke than those with normal cIMT (≤0.90 mm). These patients had more permanent/persistent NVAF and CHA2DS2-VASc score ≥ 2 (p < 0.0001) compared to those with cIMT <0.90 mm. Excluding all patients affected by previous cardiovascular disease, logistic regression analysis showed that independent predictors of abnormal cIMT were: age class 65-74 yrs. (p < 0.001), age class ≥75 yrs. (p < 0.001), arterial hypertension (p < 0.001), calcium-channel blockers use (p < 0.001) and persistent/permanent NVAF (p = 0.001).
  
  
  CONCLUSIONS
  Our findings show a high prevalence of abnormal cIMT in NVAF patients, reinforcing the concept that NVAF and systemic atherosclerosis are closely associated. Abnormal cIMT was particularly evident in persistent/permanent NVAF suggesting a more elevated atherosclerotic burden in patients with long-standing NVAF.
  
  
  BACKGROUND
  http://clinicaltrials.gov/ct2/show/NCT01161251.
authors.affiliation: I Clinica Medica, Sapienza-University of Rome, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Proietti
authors.affiliation: I Clinica Medica, Sapienza-University of Rome, Italy.
authors.forename: Camilla
authors.initials: C
authors.lastname: Calvieri
authors.affiliation: Clinica Medica e Centro Ipertensione, Ospedale Cannizzaro, University of Catania, Catania, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Malatino
authors.affiliation: Dipartimento di Scienze Mediche e Pediatriche, University of Catania, UOSD di Angiologia Medica, Ospedale Garibaldi, Catania, Italy.
authors.forename: Santo
authors.initials: S
authors.lastname: Signorelli
authors.affiliation: First Department of Internal Medicine, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy.
authors.forename: Gino Roberto
authors.initials: GR
authors.lastname: Corazza
authors.affiliation: Department of Medical and Surgical Sciences, University of Magna-Graecia of Catanzaro, Catanzaro, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Perticone
authors.affiliation: Department of Public Health and Infectious Disease, Sapienza-University of Rome, Rome, Italy.
authors.forename: Anna Rita
authors.initials: AR
authors.lastname: Vestri
authors.affiliation: I Clinica Medica, Sapienza-University of Rome, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Loffredo
authors.affiliation: Department of Internal Medicine, University of Chieti, Chieti, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Davì
authors.affiliation: I Clinica Medica, Sapienza-University of Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Violi
authors.affiliation: I Clinica Medica, Sapienza-University of Rome, Italy. Electronic address: stefania.basili@uniroma1.it.
authors.forename: Stefania
authors.initials: S
authors.lastname: Basili
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D055109:Ankle Brachial Index; D058070:Asymptomatic Diseases; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000453:epidemiology*; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging*; D059168:Carotid Intima-Media Thickness; D016009:Chi-Square Distribution; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence; D012042:Registries; D012307:Risk Factors
keywords: Carotid intima-media thickness; Paroxysmal non valvular atrial fibrillation; Persistent/permanent non valvular atrial fibrillation; Subclinical atherosclerosis