Abstract 1186: Added Value of Carotid Artery Inter-adventitial Diameter (IAD) Relative to Intima-media Thickness (IMT) for the Prediction of Cardiovascular Events in Mesa (Multi-Ethnic Study of Atherosclerosis)
Background: Inter-adventitial diameter (IAD) of the common carotid artery is associated with atherosclerosis and hypertension. It is not clear if IAD is predictive of future cardiovascular events after accounting for traditional cardiovascular risk factors and carotid artery intima-media thickness (IMT), a measure of subclinical atherosclerosis.
Materials and Methods: Common carotid artery IAD and IMT were measured with ultrasound in 5639 participants (mean age 69.1 years) of the Multi-Ethnic Study of Atherosclerosis (MESA), a multi-ethnic cohort of Caucasian, African-American, Hispanic and Chinese participants. Incident stroke, myocardial infarction (MI) and congestive heart failure (CHF) were determined after an average follow-up of 4.8 years. Separate Cox proportional hazards models were generated after adjustment for age, gender, ethnicity, and IMT and then additionally for traditional cardiovascular risk factors and body size. Models adjusting for socioeconomic factors were considered but not reported.
Results: After adjustment for age, gender and ethnicity, IAD was a significant predictor of incident stroke and CHF. IAD was a significant predictor of incident stroke after further adjustment for risk factors and IMT; no association was seen with MI and the association with CHF was not significant (p=0.063).
Conclusions: Inter-adventitial diameters are predictive of incident stroke after adjustment for traditional cardiovascular risk factors and subclinical atherosclerosis. Although lack of statistical power might be an issue, differences with outcomes suggest the possibility of different pathological linkages with each outcome.