The role of serial carotid intima-media thickness assessment as a surrogate marker of atherosclerosis control in patients with recent myocardial infarction

INTRODUCTION: Despite percutaneous coronary intervention (PCI), patients after their first myocardial infarction (MI) are at high risk of ischemic event recurrence. Therefore, there is a need for objective markers of adequate atherosclerosis control, independent of prescribed pharmacotherapy and pat...

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Publicado no:Postepy Kardiol Interwencyjnej
Main Authors: Gacoń, Jacek, Przewlocki, Tadeusz, Podolec, Jakub, Badacz, Rafal, Pieniazek, Piotr, Ryniewicz, Wojciech, Żmudka, Krzysztof, Kabłak-Ziembicka, Anna
Formato: Artigo
Idioma:Inglês
Publicado em: Termedia Publishing House 2019
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Original Paper
Acesso em linha:https://ncbi.nlm.nih.gov/pmc/articles/PMC6488839/
https://ncbi.nlm.nih.gov/pubmed/31043988
https://ncbi.nlm.nih.govhttp://dx.doi.org/10.5114/aic.2019.81705
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spelling pubmed-64888392019-05-01 The role of serial carotid intima-media thickness assessment as a surrogate marker of atherosclerosis control in patients with recent myocardial infarction Gacoń, Jacek Przewlocki, Tadeusz Podolec, Jakub Badacz, Rafal Pieniazek, Piotr Ryniewicz, Wojciech Żmudka, Krzysztof Kabłak-Ziembicka, Anna Postepy Kardiol Interwencyjnej Original Paper INTRODUCTION: Despite percutaneous coronary intervention (PCI), patients after their first myocardial infarction (MI) are at high risk of ischemic event recurrence. Therefore, there is a need for objective markers of adequate atherosclerosis control, independent of prescribed pharmacotherapy and patients’ compliance. Such a potential indicator of major adverse cerebral and coronary event (MACCE) risk might be change in carotid intima-media thickness (CIMT), which indicates atherosclerosis growth. AIM: To evaluate the potential associations between CIMT changes and the incidence of MACCE and recurrent MI. MATERIAL AND METHODS: The CIMT assessments at baseline and during 2 follow-up visits were performed in 215 patients admitted with MI, in whom PCI was performed for an index lesion, followed by best medical treatment. The incidences of MACCE (cardiovascular death, recurrent MI, ischemic stroke) and new onset angina were recorded prospectively. RESULTS: The MACCE were recorded in 65 (30.2%) patients and angina due to coronary lesion progression (CLP) in 27 (12.5%) patients. Although initial CIMT values were similar in patients who suffered MACCE vs. MACCE-free patients (1.43 ±0.40 vs. 1.45 ±0.44 mm; p = 0.486), patients in whom MACCE occurred had greater annual CIMT growth as assessed at the first (0.024 ±0.12 vs. 0.009 ±0.16 mm/year; p < 0.001) and subsequent follow-up visit (0.050 ±0.1 vs. 0.001 ±0.1 mm/year; p < 0.001), in mean 36.5 ±29.3 and 53.3 ±37.1 months, respectively. An optimal cut-off value for annual CIMT change of > 0.003 mm/year (sensitivity: 84.5%, specificity: 49.3%) for MI plus CLP (AUC = 0.673) occurred an independent indicator of MACCE (HR = 3.00; 95% CI: 1.496–6.016), recurrent MI (HR = 4.59, 95% CI: 1.591–13.217), and MI plus CLP (HR = 3.50, 95% CI: 1.759–6.964). CONCLUSIONS: Annual CIMT change might be a potentially valuable marker of atherosclerosis response to post-MI treatment. Termedia Publishing House 2019-03-04 2019 /pmc/articles/PMC6488839/ /pubmed/31043988 http://dx.doi.org/10.5114/aic.2019.81705 Text en Copyright: © 2019 Termedia Sp. z o. o. http://creativecommons.org/licenses/by-nc-sa/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
institution US NLM
collection PubMed Central
language Inglês
format Artigo
topic Original Paper
spellingShingle Original Paper
Gacoń, Jacek
Przewlocki, Tadeusz
Podolec, Jakub
Badacz, Rafal
Pieniazek, Piotr
Ryniewicz, Wojciech
Żmudka, Krzysztof
Kabłak-Ziembicka, Anna
The role of serial carotid intima-media thickness assessment as a surrogate marker of atherosclerosis control in patients with recent myocardial infarction
description INTRODUCTION: Despite percutaneous coronary intervention (PCI), patients after their first myocardial infarction (MI) are at high risk of ischemic event recurrence. Therefore, there is a need for objective markers of adequate atherosclerosis control, independent of prescribed pharmacotherapy and patients’ compliance. Such a potential indicator of major adverse cerebral and coronary event (MACCE) risk might be change in carotid intima-media thickness (CIMT), which indicates atherosclerosis growth. AIM: To evaluate the potential associations between CIMT changes and the incidence of MACCE and recurrent MI. MATERIAL AND METHODS: The CIMT assessments at baseline and during 2 follow-up visits were performed in 215 patients admitted with MI, in whom PCI was performed for an index lesion, followed by best medical treatment. The incidences of MACCE (cardiovascular death, recurrent MI, ischemic stroke) and new onset angina were recorded prospectively. RESULTS: The MACCE were recorded in 65 (30.2%) patients and angina due to coronary lesion progression (CLP) in 27 (12.5%) patients. Although initial CIMT values were similar in patients who suffered MACCE vs. MACCE-free patients (1.43 ±0.40 vs. 1.45 ±0.44 mm; p = 0.486), patients in whom MACCE occurred had greater annual CIMT growth as assessed at the first (0.024 ±0.12 vs. 0.009 ±0.16 mm/year; p < 0.001) and subsequent follow-up visit (0.050 ±0.1 vs. 0.001 ±0.1 mm/year; p < 0.001), in mean 36.5 ±29.3 and 53.3 ±37.1 months, respectively. An optimal cut-off value for annual CIMT change of > 0.003 mm/year (sensitivity: 84.5%, specificity: 49.3%) for MI plus CLP (AUC = 0.673) occurred an independent indicator of MACCE (HR = 3.00; 95% CI: 1.496–6.016), recurrent MI (HR = 4.59, 95% CI: 1.591–13.217), and MI plus CLP (HR = 3.50, 95% CI: 1.759–6.964). CONCLUSIONS: Annual CIMT change might be a potentially valuable marker of atherosclerosis response to post-MI treatment.
author Gacoń, Jacek
Przewlocki, Tadeusz
Podolec, Jakub
Badacz, Rafal
Pieniazek, Piotr
Ryniewicz, Wojciech
Żmudka, Krzysztof
Kabłak-Ziembicka, Anna
author_facet Gacoń, Jacek
Przewlocki, Tadeusz
Podolec, Jakub
Badacz, Rafal
Pieniazek, Piotr
Ryniewicz, Wojciech
Żmudka, Krzysztof
Kabłak-Ziembicka, Anna
author_sort Gacoń, Jacek
title The role of serial carotid intima-media thickness assessment as a surrogate marker of atherosclerosis control in patients with recent myocardial infarction
title_short The role of serial carotid intima-media thickness assessment as a surrogate marker of atherosclerosis control in patients with recent myocardial infarction
title_full The role of serial carotid intima-media thickness assessment as a surrogate marker of atherosclerosis control in patients with recent myocardial infarction
title_fullStr The role of serial carotid intima-media thickness assessment as a surrogate marker of atherosclerosis control in patients with recent myocardial infarction
title_full_unstemmed The role of serial carotid intima-media thickness assessment as a surrogate marker of atherosclerosis control in patients with recent myocardial infarction
title_sort role of serial carotid intima-media thickness assessment as a surrogate marker of atherosclerosis control in patients with recent myocardial infarction
publisher Termedia Publishing House
container_title Postepy Kardiol Interwencyjnej
publishDate 2019
url https://ncbi.nlm.nih.gov/pmc/articles/PMC6488839/
https://ncbi.nlm.nih.gov/pubmed/31043988
https://ncbi.nlm.nih.govhttp://dx.doi.org/10.5114/aic.2019.81705
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