title: Associations between common carotid artery diameter, Framingham risk score and cardiovascular events.
abstract: OBJECTIVE
  Vascular biomarkers are associated with risk burden and are capable to predict the development of future cardiovascular (CV) events; yet, their additive predictive value over and above established risk algorithms seems to be only modest. The present study evaluated the cross-sectional associations between vascular biomarkers, 10-year Framingham risk (FR) and prevalent CV events in a population with a high prevalence of hypertension and diabetes.
  
  
  RESULTS
  As many as 681 subjects (419 men, age = 60 ± 10 years, 282 diabetics, 335 hypertensives, mean FR score = 22.5 ± 16.5%) underwent an integrated vascular examination including: radiofrequency-based ultrasound of common carotid artery (cca) to measure intima-media thickness (IMT), inter-adventitial diameter (IAD) and local pulse wave velocity (PWV); applanation tonometry to assess carotid pulse pressure (PP) and augmentation index (AIx); carotid-femoral PWV (cfPWV) measurement. One hundred and thirty-five subjects (19.8%) had history of CV events, and CV events were independently associated with male sex, age, antihypertensive treatment, current smoking, HDL-cholesterol and ccaIAD. In logistic regression model, only ccaIAD was associated with prevalence of CV events after adjustment for FR score, with the OR of 1.71 [1.34-2.19] (P < 0.0001) that remained unchanged when ccaIMT was included into the model (OR = 1.76 [1.36-2.27]; P < 0.0001). The association between prevalent CV events and ccaIAD was significant (OR of 1.65 [1.24-2.20]; P = 0.0005) also in a subgroup of subjects being at a high 10-year risk of CV disease (N = 330).
  
  
  CONCLUSIONS
  In a population with a high prevalence of diabetes and hypertension, ccaIAD was the only vascular measure associated with prevalent CV events, independently of FR score.
authors.affiliation: Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy; Esaote SpA, Genova, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Kozakova
authors.affiliation: Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Morizzo
authors.affiliation: Villa Sofia Hospital, Palermo, Italy.
authors.forename: S
authors.initials: S
authors.lastname: La Carrubba
authors.affiliation: Department of Surgical, Medical Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy.
authors.forename: I
authors.initials: I
authors.lastname: Fabiani
authors.affiliation: Imaging Department, Fondazione Toscana G. Monasterio, Massa-Pisa, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Della Latta
authors.affiliation: Imaging Department, Fondazione Toscana G. Monasterio, Massa-Pisa, Italy.
authors.forename: J
authors.initials: J
authors.lastname: Jamagidze
authors.affiliation: Department of Surgical, Medical Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Chiappino
authors.affiliation: Imaging Department, Fondazione Toscana G. Monasterio, Massa-Pisa, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Di Bello
authors.affiliation: Imaging Department, Fondazione Toscana G. Monasterio, Massa-Pisa, Italy. Electronic address: carlo.palombo@unipi.it.
authors.forename: C
authors.initials: C
authors.lastname: Palombo
mesh_terms: D000368:Aged; D001794:Blood Pressure; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000503:physiopathology; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging* / Q000503:physiopathology; D059168:Carotid Intima-Media Thickness; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology; D007558:Italy / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008365:Manometry; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D015995:Prevalence; D063177:Pulse Wave Analysis; D018570:Risk Assessment; D012307:Risk Factors; D059289:Vascular Stiffness
keywords: Arterial stiffness; Cardiovascular risk; Common carotid artery diameter; Framingham risk score; Intima-media thickness; Obesity; Vascular biomarkers