Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2009 Mar;84(3):229-33.
doi: 10.4065/84.3.229.

Carotid intima-media thickness and coronary artery calcium score as indications of subclinical atherosclerosis

Steven J Lester  1 , Mackram F Eleid, Bijoy K Khandheria, R Todd Hurst
Affiliations

Carotid intima-media thickness and coronary artery calcium score as indications of subclinical atherosclerosis

Steven J Lester et al. Mayo Clin Proc. 2009 Mar.

Abstract

Objective: To determine the ability of carotid intima-media thickness (CIMT) and coronary artery calcium score (CACS) to detect subclinical atherosclerosis in a young to middle-aged, low-risk, primary-prevention population.

Patients and methods: Patients aged 36 to 59 years who underwent determination of CIMT and CACS at our institution between May 1, 2004, and April 1, 2008, were included in the study. Those with diabetes mellitus or a history of coronary, peripheral, or cerebral vascular disease were excluded. Other information, such as Framingham risk score (FRS), was obtained by a review of clinical and laboratory data.

Results: Of 118 patients, 89 (75%) had a CACS of zero and 94 (80%) were men; mean +/- SD age was 48.9+/-5.7 years. The mean FRS of this group was 4.0; 86 patients (97%) were considered at low risk (<1% annualized rate) of cardiovascular events. Evidence of carotid atherosclerosis was found in 42 (47%; 95% confidence interval, 37%-58%) of these 89 patients; carotid plaque was found in 30 (34%); and CIMT above the 75th percentile was found in 12 (13%) of age-, sex-, and race-matched control patients. Of the 40 patients with low-risk CIMT (below the 50th percentile), 4 (10%) had a CACS at or above the 50th percentile.

Conclusion: Subclinical vascular disease can be detected by CIMT evaluation in young to middle-aged patients with a low FRS and a CACS of zero. These findings have important implications for vascular disease screening and the implementation of primary-prevention strategies.

PubMed Disclaimer

Figures

FIGURE 1.
FIGURE 1.
Carotid intima-media thickness (CIMT) findings in 89 patients with a coronary artery calcium score of zero.
FIGURE 2.
FIGURE 2.
Percentage of patients whose risk of cardiovascular disease was restratified to a higher level because of evaluations of either carotid intima-media thickness (CIMT) or coronary artery calcium score (CACS).
See this image and copyright information in PMC

Comment in

References

    1. Machiavelli N. The Portable Machiavelli Bondanella PE, Musa M, trans-eds. London, England: Penguin; 2005.
    1. World Health Organization Web site Cardiovascular disease: prevention and control. 2003. http://www.who.int/dietphysicalactivity/publications/facts/cvd/en/ http://www.who.int/dietphysicalactivity/publications/facts/cvd/en/ Accessed January 6, 2009.
    1. Thom T, Haase N, Rosamond W, et al. Heart disease and stroke statistics—2006 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee [published corrections appear in Circulation. 2006;113(14):e696 and 2006;114(23):e630] Circulation 2006February14;113(6):e85-e151 Epub 2006 Jan 11 - PubMed
    1. Cannon CP, Braunwald E, McCabe CH, et al. Pravastatin or Atorvastatin Evaluation and Infection Therapy-Thrombolysis in Myocardial Infarction 22 Investigators Intensive versus moderate lipid lowering with statins after acute coronary syndromes [published correction appears in N Engl J Med. 2006; 354(7):778] N Engl J Med. 2004April8;350(15):1495-1504 Epub 2004 Mar 8 - PubMed
    1. Downs JR, Clearfield M, Weis S, et al. AFCAPS/TexCAPS Research Group Primary prevention of acute coronary events with lovastatin in men and women with average cholesterol levels: results of AFCAPS/TexCAPS. JAMA 1998;279(20):1615-1622 - PubMed