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THE ROLE OF CAROTID INTIMA-MEDIA THICKNESS AND MICROALBUMINURIA ASSESSMENT IN CARDIOVASCULAR RISK EVALUATION IN PATIENTS WITH POLYVASCULAR ATHEROSCLEROSIS

Objectives To evaluate the relationship between CIMT, MA, atherosclerosis extent and CV event rates in patients with established atherosclerosis. Methods Baseline mean-CIMT and MA was assessed in 149 polyvascular atherosclerosis patients with angiographic arterial stenosis ≥50%, who underwent revascularisation procedure in ≥1 arterial territory, and in 40 control subjects without significant lesions. Results For CIMT≥1.38 mm (≥3rd quartile), the sensitivity and specificity of ≥3-territory involvement were 90.0% and 82.6%. MA≥6.85 mg/dl (≥3rd quartile), the sensitivity and specificity of ≥2-territory involvement were 54.9% and 83.3%. CV events occurred in 104 subjects. The Kaplan-Meier 2-year CV event-free survival was 93.9% and 95.7%; 95.7% and 89.6%; 73.9% and 72.3%; 59.6% and 66% in patients with mean-CIMT and MA values in the 1st; 2nd; 3rd and 4th quartile. The multivariable Cox proportional hazard model identified: mean-CIMT ≥1.38 mm (RR=1.83; CI 1.049 to 3.196; p<0.001), MA≥6.84 mg/dl (RR=0.99; CI 0.576 to 1.703; p<0.001). Inclusion of CIMT into the stratification model significantly improved the prediction of CV event risk (Δχ2=7.098, p<0.001) whereas the impact of the MA is not significant (△χ2=0.002, p<0.001). Conclusions In patients undergoing revascularisation procedure (s), CIMT has an important and independent contribution to further CV risk stratification. The mean-CIMT value ≥1.38 mm is associated with 1.8-fold increased risk of adverse CV events and the MA value ≥6.85 mg/dl is associated with nearly 1-fold increased risk of adverse CV events.