Published Online
on February 10, 2003

A more recent version of this article appeared on March 4, 2003

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Submitted on September 9, 2002
Revised on November 15, 2002
Accepted on November 15, 2002

Carotid Arterial Structure in Patients With Documented Coronary Artery Disease and Disease-Free Control Subjects

James G. Terry MS, Rong Tang MD, Mark A. Espeland PhD, Donna H. Davis BS, Jose L.C. Vieira MD, PhD, Michele F. Mercuri MD, PhD, and John R. Crouse III MD^*

From the Departments of Internal Medicine (J.G.T., D.H.D, J.L.C.V., J.R.C.), Division of Vascular Ultrasound Research (R.T., M.F.M.), and Public Health Sciences (M.A.E., J.R.C.), Wake Forest University School of Medicine, Winston-Salem, NC. Dr Mercuri is currently employed by Merck & Co Inc, Rahway, NJ.

^* To whom correspondence should be addressed. E-mail: jrcrouse{at}wfubmc.edu.

Background--Although atherosclerosis often leads to lumen narrowing and symptomatic cardiovascular disease, it is now recognized that arteries have the potential to compensate by enlarging in response to atherosclerosis. We tested the hypotheses that carotid arterial interadventitial (IA) and lumen diameters were related to wall thickness and that carotid arterial diameters of individuals with coronary artery disease (CAD) differed from those of CAD-free controls.

Methods and Results--We measured lumen diameter, IA diameter, and intima-media thickness (IMT) using B-mode ultrasound in the common and internal carotid arteries of 141 CAD case patients and 139 disease-free control subjects. Common carotid IA diameter was greater in CAD cases than controls after adjustment for age, height, and sex (P<0.01). Common carotid lumen diameter was marginally larger in individuals with greater IMT (P=0.06) but was not associated with case status. Conversely, mean internal carotid IA and lumen diameters were smaller in CAD cases than controls in both univariable and multivariable models (both P<0.001), and lumina were smaller in individuals with greater IMT. Despite these cross-sectional differences in carotid artery dimensions, we were unable to detect any statistically significant interactive effects of CAD case status on the association of IMT with arterial dimensions.

Conclusions--Internal carotid artery lumen and IA diameters are both smaller in CAD cases than controls. The association of increased IMT with arterial dimensions varies in a manner that is segment-specific for the common and internal carotid arteries.

Key words: carotid arteries • atherosclerosis • coronary disease • compensation

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