Intima-media thickness is a useful marker of the extent of coronary artery disease in patients with impaired renal function

A Lisowska, W J Musiał, P Lisowski, M Knapp, J Małyszko, S Dobrzycki
Atherosclerosis 2009, 202 (2): 470-5

OBJECTIVE: The aim of the study was the assessment of intima-media thickness (IMT) in peripheral arteries (the carotid and the femoral artery) and its correlation with the extent of coronary artery disease (CAD). The second task was the analysis of the renal function's influence within IMT complex.

METHODS: 231 patients (men, mean age 52.8), who had undergone coronary angiography due to symptoms of CAD were enrolled. The ultrasound measurement of IMT in the common carotid artery (CCA), carotid bulb and common femoral artery (CFA) was performed. The relationship between IMT, renal function and the extent of CAD was evaluated.

RESULTS: Significantly higher values of IMT in the peripheral arteries were observed in patients with CAD than in those without (CCA-0.91 vs 0.61 mm, carotid bulb-1.31 vs 0.67, CFA-1.38 vs 0.63 respectively, p<0.0001). The GFR values in the CAD patients significantly negatively correlated with IMT complex in CCA (p<0.001) and carotid bulb (p<0.05). Lower values of GFR in patients with three-vessel disease were observed than in those patients with one- or two-vessel disease (p<0.05). In multifactoral analysis (post-hoc NIR test) we found that glomerular filtration rate (GFR) is strongly determined by age (p<0.0001), BMI (p<0.0001), value of carotid intima-media thickness (p<0.001), value of IMT in the carotid bulb (p<0.02) and the treatment with ACE-I (p<0.05). In multifactoral analysis we did not find any statistical influence of lipid profile and glucose disturbances on GFR.

CONCLUSIONS: Higher peripheral artery IMTs in patients with CAD than in those without and patients with three-vessel disease indicate that IMT may be used as an early marker of atherosclerosis and reflect the severity of CAD. A significant negative correlation between the value of a GFR and the IMT confirmed the usefulness of this noninvasive method for the estimation of preclinical stages of atherosclerotic changes' development in patients with impaired renal function.

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