INFLUENZA DELL’ATEROSCLEROSI CAROTIDEA PRECLINICA SUGLI EVENTI CEREBRO- E CARDIOVASCOLARI IN 5 ANNI DI FOLLOW-UP.INFLUENCE OF PRECLINICAL CAROTID ATHEROSCLEROSIS ON CEREBRO- AND CARDIOVASCULAR EVENTS IN A FIVE YEARS FOLLOW-UP

Salvatore Novo, Egle Corrado, Giuseppina Novo, Giuseppe Coppola, Ida Maria Muratori

Research output: Contribution to journalArticle

Abstract

[automatically translated] Introduction: many studies have used the assessment of carotid intima-media thickness (IMT) as markers of atherosclerosis (ATS) preclinical and has been widely demonstrated that IMT correlates with the presence of coronary ATS and is predictive of cardiovascular events is that cerebrovascular. Aim of the study: whether in the presence of asymptomatic carotid ATS preclinical, average carotid intimal thickening (IMT) and plaque asymptomatic carotid artery (PCA), add more information in risk stratification allowing to identify people who may benefit from more aggressive treatment even drug, the risk factors present. Materials and Methods: We studied a selected population of 454 subjects, with a mean age of 57 +/- 10 years, and with more cardiovascular risk factors (FR), asymptomatic for cardiovascular disease. All subjects underwent clinical and pharmacological history and a careful physical examination with assessment of the most common FR, and a venipuncture for lipid evaluation and blood glucose. All subjects underwent ultrasound examination of the carotid arteries for IMT assessment or PCA. We then calculated for each subject the RCVG, using as a system of stratification of the risk of the Project Heart score; 422 subjects had a RCVG <20%. The subjects performed a follow-up of 5 years, with analysis of cardiovascular and cerebrovascular events, fatal and nonfatal, considering as an endpoint of cardiovascular death, sudden death, nonfatal myocardial infarction, TIA, the non-fatal stroke and interventions of coronary or peripheral revascularization with angioplasty or surgery. Results: During the follow-up we found an incidence of events, fatal and nonfatal, by 15% in subjects with PCA, by 13% in patients with carotid IMT and 8% in those with normal carotid arteries. Conclusion: in a selected population, with a mean age of 57 +/- 10 years and with an FR cluster, the presence of carotid ATS preclinical could be considered an additional risk marker; In fact, in individuals with increased IMT or presence of PCA and the intermediate / low risk, we have highlighted a risk of CV events at 5 years of 13% and 15%, respectively, compared with 8% of those with normal carotid, with an increase in the RR of events respectively of 62.5% and 87, 5% for the same category of risk. In conclusion, in patients with a mean age of 57 +/- 10 years, with a cluster of cardiovascular FR RCVG and <20%, the evaluation of carotid IMT allows to identify some in which it is desirable to more intensive treatment of risk factors editable.
Original languageItalian
Number of pages9
JournalGIORNALE ITALIANO DI CARDIOLOGIA PRATICA
Volume2009
Publication statusPublished - 2009

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