Increased common carotid artery wall thickness is associated with rapid progression of asymptomatic carotid stenosis

J Neuroimaging. 2014 Sep-Oct;24(5):473-8. doi: 10.1111/jon.12068. Epub 2013 Nov 25.

Abstract

Background and purposes: This study aimed to identify clinical and ultrasound imaging predictors of progression of carotid luminal narrowing in subjects with asymptomatic moderate internal carotid artery (ICA) stenosis.

Methods: A total of 571 subjects with asymptomatic moderate (50-69%) ICA stenoses were enrolled. They underwent ultrasound examination at baseline and after 12 months. Demographics, vascular risk factors, medications, plaque characteristics (surface and echogenicity) and common carotid intima-media thickness (IMT) were collected. At the follow-up examination, any change of ICA stenosis was graded in three categories (i) ≥70% to near occlusion, (ii) near occlusion, and (iii) occlusion. Progression of stenosis was defined as an increase in the stenosis degree by at least one category from baseline to follow-up.

Results: At 12 months, progression occurred in 142 subjects (prevalence rate 25%). At the multivariable logistic model, pathological IMT values (considered as binary variable: normal: ≤1 mm vs. pathologic: >1 mm) significantly predicted the risk for plaque progression after adjusting the model for possible confounders (OR 2.28, 95% CI 1.18-4.43, P = .014, multivariable logistic model).

Conclusions: Our results confirm the role of carotid wall thickening as a marker of atherosclerosis. Carotid IMT measurement should be considered to implement risk stratification in patients with asymptomatic carotid disease.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Carotid Artery, Common / diagnostic imaging*
  • Carotid Intima-Media Thickness / statistics & numerical data*
  • Carotid Stenosis / diagnostic imaging*
  • Carotid Stenosis / epidemiology*
  • Disease Progression
  • Female
  • Humans
  • Italy / epidemiology
  • Male
  • Prevalence
  • Reproducibility of Results
  • Risk Factors
  • Sensitivity and Specificity