Abstract 950: Should We Measure Intima Media Thickness In Patients With Peripheral Arterial Disease?
Background: Carotid intima-media thickness (IMT) is a marker of early atherosclerosis. Patients with peripheral arterial disease (PAD) have advanced atherosclerosis and a high cardiovascular event rate. The aim of this study was to evaluate, whether measurement of carotid IMT adds prognostic information in PAD patients.
Methods: We included 165 patients (mean age 64.5 ± 9 years, 71.5% men) with PAD. In all patients IMT was measured at both common carotid arteries and the mean IMT was used for further evaluation. Carotid IMT of more than 0.9 mm was defined as thickened. After a median follow-up of 6.5 years in total 33 patients (20%) died from cardiovascular causes.
Results: Mean IMT was 0.75 ± 0.19 mm and in 30 patients (18.2%) an IMT ≥ 0.9 mm could be detected. Cardiovascular mortality was significantly higher in patients with PAD and IMT ≥ 0.9 mm than in patients with IMT ≥ 0.9 mm (IMT ≥ 0.9 mm = 40.0 % versus IMT < 0.9 mm = 15.6 %; P=0.002, figure⇓). In a fully adjusted Cox regression analysis (adjusted for age, sex, diabetes, hypertension, high density lipoprotein cholesterol, smoking, body mass index and acute coronary syndrome) a carotid IMT ≥ 0.9 mm could not be identified as an independent predictor for cardiovascular death (Hazard Ratio (95% Confidence Interval) = 2.0 (0.9 – 4.2), P=0.09).
Conclusion: Patients with PAD and a carotid IMT ≥ 0.9 mm had a higher cardiovascular mortality than patients with normal IMT. But an increased carotid IMT could not be identified as independent predictor for cardiovascular mortality. Therefore it should be discussed whether IMT measurement adds prognostic impact in patients with PAD.