title: Neither endothelial function nor carotid artery intima-media thickness predicts coronary computed tomography angiography plaque burden in clinically healthy subjects: a cross-sectional study.
abstract: BACKGROUND
  Cardiovascular risk assessment is usually based on traditional risk factors and risk assessment algorithms. However, a number of risk markers that might provide additional predictive power have been identified. Endothelial function determined by digital reactive hyperemia peripheral arterial tonometry (RH-PAT) and carotid artery intima-media thickness (IMT) have both been proposed as surrogate markers for coronary artery disease (CAD). We aimed to examine the ability of RH-PAT and IMT to predict coronary computed tomography angiography (CTA) plaque burden in clinically healthy subjects.
  
  
  METHODS
  Fifty-eight clinically healthy volunteers (50-73 years old) underwent testing for RH-PAT and IMT as well as coronary CTA, including coronary artery calcium (CAC) scoring. Coronary CTA was analyzed with respect to any atheromatous plaques, stenotic as well as non-stenotic. The Mann-Whitney U-test was used to compare the groups with and without CAD and the Spearman test was used to test for correlation between variables.
  
  
  RESULTS
  Twenty-five (43 %) subjects had normal coronary arteries, without any signs of atherosclerosis. The median (range) number of diseased segments was 1 (0-10), RH-PAT index 2.2 (1.4-4.9), IMT 0.70 (0.49-0.99) mm and CAC 4 (0-1882). There was no association between presence or extent of CAD and RH-PAT index (Spearman correlation coefficient rs = 0.13) or IMT (rs = 0.098). As expected, CAC was strongly correlated to presence and extent of CAD by coronary CTA (rs =0.86; p < 0.0001).
  
  
  CONCLUSIONS
  Neither evaluation of endothelial function by RH-PAT nor assessment of carotid artery IMT can reliably be used to predict coronary CTA plaque burden in clinically healthy subjects.
authors.affiliation: Department of Radiology, Karolinska University Hospital Huddinge, Stockholm, 141 86, Sweden. elin.bacsovics.brolin@ki.se.|Department of Clinical Science, Intervention and Technology, Division of Medical Imaging and Technology at Karolinska Institutet, Stockholm, 141 86, Sweden. elin.bacsovics.brolin@ki.se.
authors.forename: Elin B
authors.initials: EB
authors.lastname: Brolin
authors.affiliation: Department of Cardiology, Oslo University Hospital Ullevål; Institute of Clinical Sciences, University of Oslo, Oslo, Norway. stefan.agewall@ki.se.
authors.forename: Stefan
authors.initials: S
authors.lastname: Agewall
authors.affiliation: Department of Radiology, Karolinska University Hospital Huddinge, Stockholm, 141 86, Sweden. torkel.brismar@ki.se.|Department of Clinical Science, Intervention and Technology, Division of Medical Imaging and Technology at Karolinska Institutet, Stockholm, 141 86, Sweden. torkel.brismar@ki.se.
authors.forename: Torkel B
authors.initials: TB
authors.lastname: Brismar
authors.affiliation: Department of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden. kenneth.caidahl@ki.se.|Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden. kenneth.caidahl@ki.se.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Caidahl
authors.affiliation: Institution for Clinical Science and Education at Södersjukhuset, Karolinska Institutet, Stockholm, Sweden. per.tornvall@sodersjukhuset.se.
authors.forename: Per
authors.initials: P
authors.lastname: Tornvall
authors.affiliation: Department of Radiology, Karolinska University Hospital Huddinge, Stockholm, 141 86, Sweden. kerstin.cederlund@ki.se.|Department of Clinical Science, Intervention and Technology, Division of Medical Imaging and Technology at Karolinska Institutet, Stockholm, 141 86, Sweden. kerstin.cederlund@ki.se.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Cederlund
mesh_terms: D000368:Aged; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging*; D059168:Carotid Intima-Media Thickness; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000209:etiology; D003430:Cross-Sectional Studies; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging* / Q000502:physiology; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D014057:Tomography, X-Ray Computed