title: Analysis of Carotid Ultrasound Findings on Cardiovascular Events in Patients with Coronary Artery Disease during Seven-Year Follow-Up.
abstract: OBJECTIVE
  Both carotid intima-media thickness (CIMT) and carotid plaque are important factors in the primary prevention of cardiac disease. However, it is unclear which one is more important for prognosis, especially in patients with coronary artery disease (CAD).
  
  
  METHODS
  In total, 1426 consecutive CAD patients, proven by angiography, were followed-up for a mean of 85 months. The study population was divided into four groups depending on the CIMT (≥0.83 mm, >95 percentile in Korea) and the presence or absence of carotid plaque.
  
  
  RESULTS
  Patients with carotid plaque and thick CIMT (n=237, 16.6%) had a higher prevalence of hypertension, diabetes mellitus, and dyslipidemia than those had plaque and thin CIMT (n=213, 14.9%), those without plaque and thick CIMT (n=265, 18.6%) and those without plaque and thin CIMT (n=711, 49.9%). The patients with carotid plaque and thick CIMT group had a higher cardiac mortality rate (20.7% vs. 13.1%, 9.4% and 3.9%, respectively, p<0.001) and higher major adverse cardiovascular events (MACE) including death, acute myocardial infarction, and stroke (27.8% vs. 18.8%, 15.5% and 9.3%, respectively, p<0.001) than any other groups. Multivariate Cox regression analysis showed that the presence of carotid plaque with thick CIMT had the highest hazard ratio (HR) compared to other groups (HR 2.23 vs. 1.81, 2.01) for cardiac mortality. Also, carotid plaque had a higher HR than CIMT for mortality (HR 1.56 vs. 1.37) and MACE (HR 1.54 vs. 1.36) in the total study population.
  
  
  CONCLUSIONS
  Carotid plaque is a more important prognostic factor than CIMT in patients with CAD, and adding a thick CIMT to carotid plaque increases the prognostic power for cardiac events.
authors: Division of Cardiology, Heart Center, Konyang University Hospital, Daejeon, Korea.
authors: Hyung Bin
authors: HB
authors: Yuk
authors: Division of Cardiology, Heart Center, Konyang University Hospital, Daejeon, Korea.
authors: Hyun Woong
authors: HW
authors: Park
authors: Division of Cardiology, Heart Center, Konyang University Hospital, Daejeon, Korea.
authors: Ik Ju
authors: IJ
authors: Jung
authors: Division of Cardiology, Heart Center, Konyang University Hospital, Daejeon, Korea.
authors: Wan Ho
authors: WH
authors: Kim
authors: Division of Cardiology, Heart Center, Konyang University Hospital, Daejeon, Korea.
authors: Ki-Hong
authors: KH
authors: Kim
authors: Division of Cardiology, Heart Center, Konyang University Hospital, Daejeon, Korea.
authors: Dong-Ju
authors: DJ
authors: Yang
authors: Division of Cardiology, Heart Center, Konyang University Hospital, Daejeon, Korea.
authors: Yo Han
authors: YH
authors: Park
authors: Division of Cardiology, Heart Center, Konyang University Hospital, Daejeon, Korea.
authors: Yong Kyun
authors: YK
authors: Kim
authors: Division of Cardiology, Heart Center, Konyang University Hospital, Daejeon, Korea.
authors: In Geol
authors: IG
authors: Song
authors: Division of Cardiology, Heart Center, Konyang University Hospital, Daejeon, Korea.
authors: Jang-Ho
authors: JH
authors: Bae
keywords: Carotid artery plaque; Carotid intima-media thickness; Coronary artery disease; Death
references: Int J Cardiol. 2013 Jul 1;166(3):658-63
references: 22192294
references: Arterioscler Thromb Vasc Biol. 2010 Feb;30(2):177-81
references: 19679833
references: Arterioscler Thromb Vasc Biol. 2006 Oct;26(10 ):2380-5
references: 16902160
references: Stroke. 2006 Jan;37(1):87-92
references: 16339465
references: Am J Epidemiol. 2000 Mar 1;151(5):478-87
references: 10707916
references: Eur Heart J. 2001 Jan;22(1):62-72
references: 11133211
references: N Engl J Med. 1999 Jan 7;340(1):14-22
references: 9878640
references: Am J Epidemiol. 1997 Sep 15;146(6):483-94
references: 9290509
references: Atherosclerosis. 2010 Aug;211(2):451-5
references: 20362290
references: Arterioscler Thromb Vasc Biol. 2006 Mar;26(3):656-62
references: 16357319
references: Arterioscler Thromb Vasc Biol. 2010 Feb;30(2):182-5
references: 19948842
references: Am J Cardiol. 2013 Jul 1;112(1):27-33
references: 23558041
references: Eur Heart J Cardiovasc Imaging. 2014 Jul;15(7):736-46
references: 24399339
references: Eur Heart J. 2003 Jun;24(11):987-1003
references: 12788299
references: J Am Coll Cardiol. 2010 Apr 13;55(15):1600-7
references: 20378078
references: Am J Cardiol. 2006 Jul 17;98(2A):2H-15H
references: 16843744
references: Atherosclerosis. 2012 Jan;220(1):128-33
references: 21764060
references: Int J Epidemiol. 2002 Dec;31(6):1253-62; discussion 1262-64
references: 12540731
references: Stroke. 1999 Apr;30(4):841-50
references: 10187889
references: Am J Cardiol. 2005 Jan 1;95(1):116-9
references: 15619407
references: Hypertens Res. 2013 Oct;36(10 ):902-9
references: 23823172
references: J Am Coll Cardiol. 2004 Feb 18;43(4):616-23
references: 14975472
references: Stroke. 1992 Dec;23 (12 ):1705-11
references: 1448818
references: Cardiovasc Ultrasound. 2006 Mar 24;4:16
references: 16563156
references: Stroke. 2013 Jul;44(7):1859-65
references: 23735956
references: J Am Soc Echocardiogr. 2008 Feb;21(2):93-111; quiz 189-90
references: 18261694
references: J Am Coll Cardiol. 2002 Jan 16;39(2):257-65
references: 11788217
references: Am J Cardiol. 1976 Jul;38(1):46-51
references: 132862