Circulation, Vol 82, 1230-1242, Copyright © 1990 by American Heart Association
TE Craven, JE Ryu, MA Espeland, FR Kahl, WM McKinney, JF Toole, MR McMahan, CJ Thompson, G Heiss and JR Crouse 3d
To evaluate the consistency, strength, and independence of the relation of
carotid atherosclerosis to coronary atherosclerosis, we quantified coronary
artery disease risk factors and extent of carotid atherosclerosis (B-mode
score) in 343 coronary artery disease patients and 167 disease-free control
patients. In univariable analyses, there was a strong association between
coronary status and extent of carotid artery disease in men and women older
than and younger than 50 years (p less than 0.001 for men and women greater
than 50 years, p less than 0.001 for women less than or equal to 50 years,
p = 0.045 for men less than or equal to 50). The relation remained strong
after control for age in men and women older than 50 years and in women
younger than 50 (p less than 0.001 for men and women greater than 50 years,
p = 0.003 for women less than or equal to 50) but did not persist after
control for age in men younger than 50. Logistic models that included
coronary disease risk factors, with or without B-mode score, as independent
variables and presence or absence of coronary disease as the outcome
variable indicated that the extent of carotid atherosclerosis was a strong,
statistically significant independent variable in models for men and women
older than 50 years of age. Next, we examined the usefulness of B-mode
score as an aid in screening for coronary artery disease in men and women
older than 50 years. Classification rules, both including and excluding
B-mode score, were developed based on logistic regression and, for
comparison, recursive partitioning (decision trees). The performance of
these rules and the bias of their performance statistics were estimated.
The improved classification of the study sample when B-mode score was
incorporated in the rule was statistically significant only for men (p =
0.015). However, the addition of B-mode score was found to 1) increase the
median discrimination score for both sex groups based on the logistic
model, and 2) yield better sensitivities and specificities for rules based
on recursive partitioning. Thus B-mode score is strongly, consistently, and
independently associated with coronary artery disease in patients older
than 50 and is at least as useful as well-known risk factors for
identifying patients with coronary artery disease.
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Evaluation of the associations between carotid artery atherosclerosis and coronary artery stenosis. A case-control study
Department of Medicine, Wake Forest University Medical Center, Bowman Gray School of Medicine, Winston-Salem, NC 27103.
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 B. Suwelack, J. Witta, M. Hausberg, S. Muller, K. Rahn, and M. Barenbrock Studies on structural changes of the carotid arteries and the heart in asymptomatic renal transplant recipients Nephrol. Dial. Transplant., January 1, 1999; 14(1): 160 - 165. [Abstract] [PDF]
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M.-L. M. Gronholdt Ultrasound and Lipoproteins as Predictors of Lipid-Rich, Rupture-Prone Plaques in the Carotid Artery Arterioscler Thromb Vasc Biol, January 1, 1999; 19(1): 2 - 13. [Abstract] [Full Text] [PDF]
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H. S. Markus, Y. Ruigrok, N. Ali, and J. F. Powell Endothelial Nitric Oxide Synthase Exon 7 Polymorphism, Ischemic Cerebrovascular Disease, and Carotid Atheroma Stroke, September 1, 1998; 29(9): 1908 - 1911. [Abstract] [Full Text] [PDF]
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K. A. Matthews, J. F. Owens, L. H. Kuller, K. Sutton-Tyrrell, H. C. Lassila, and S. K. Wolfson Stress-Induced Pulse Pressure Change Predicts Women's Carotid Atherosclerosis Stroke, August 1, 1998; 29(8): 1525 - 1530. [Abstract] [Full Text] [PDF]
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C. Palombo, M. Kozakova, C. Morizzo, F. Andreuccetti, A. Tondini, P. Palchetti, G. Mirra, G. Parenti, and N. G. Pandian Ultrafast Three-Dimensional Ultrasound : Application to Carotid Artery Imaging Stroke, August 1, 1998; 29(8): 1631 - 1637. [Abstract] [Full Text] [PDF]
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S. MacMahon, N. Sharpe, G. Gamble, H. Hart, J. Scott, J. Simes, and H. White Effects of Lowering Average or Below-Average Cholesterol Levels on the Progression of Carotid Atherosclerosis : Results of the LIPID Atherosclerosis Substudy Circulation, May 19, 1998; 97(18): 1784 - 1790. [Abstract] [Full Text] [PDF]
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J. Nowak, T. Nilsson, C. Sylven, and T. Jogestrand Potential of Carotid Ultrasonography in the Diagnosis of Coronary Artery Disease : A Comparison With Exercise Test and Variance ECG Stroke, February 1, 1998; 29(2): 439 - 446. [Abstract] [Full Text] [PDF]
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T. W. Kamarck, S. A. Everson, G. A. Kaplan, S. B. Manuck, J. R. Jennings, R. Salonen, and J. T. Salonen Exaggerated Blood Pressure Responses During Mental Stress Are Associated With Enhanced Carotid Atherosclerosis in Middle-Aged Finnish Men : Findings From the Kuopio Ischemic Heart Disease Study Circulation, December 2, 1997; 96(11): 3842 - 3848. [Abstract] [Full Text]
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P. M. Okin, M. J. Roman, J. E. Schwartz, T. G. Pickering, and R. B. Devereux Relation of Exercise-Induced Myocardial Ischemia to Cardiac and Carotid Structure Hypertension, December 1, 1997; 30(6): 1382 - 1388. [Abstract] [Full Text]
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J.-J. Mourad, X. Girerd, P. Boutouyrie, S. Laurent, M. Safar, and G. London Increased Stiffness of Radial Artery Wall Material in End-Stage Renal Disease Hypertension, December 1, 1997; 30(6): 1425 - 1430. [Abstract] [Full Text]
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K. Shinozaki, Y. Hattori, M. Suzuki, Y. Hara, A. Kanazawa, H. Takaki, M. Tsushima, and Y. Harano Insulin Resistance as an Independent Risk Factor for Carotid Artery Wall Intima Media Thickening in Vasospastic Angina Arterioscler Thromb Vasc Biol, November 1, 1997; 17(11): 3302 - 3310. [Abstract] [Full Text]
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J. Spacil, R. Ceska, J. Sobra, J. Petrasek, and J. Spacil Decreasing Common Carotid Artery Intimal Thickness During Hypolipidemic Therapy Angiology, September 1, 1997; 48(9): 761 - 767. [Abstract] [PDF]
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J. Lynch, N. Krause, G. A. Kaplan, R. Salonen, and J. T. Salonen Workplace Demands, Economic Reward, and Progression of Carotid Atherosclerosis Circulation, July 1, 1997; 96(1): 302 - 307. [Abstract] [Full Text]
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J. Hulthe, J. Wikstrand, H. Emanuelsson, O. Wiklund, P. J. de Feyter, and I. Wendelhag Atherosclerotic Changes in the Carotid Artery Bulb as Measured by B-Mode Ultrasound Are Associated With the Extent of Coronary Atherosclerosis Stroke, June 1, 1997; 28(6): 1189 - 1194. [Abstract] [Full Text]
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J. Lynch, G. A. Kaplan, R. Salonen, and J. T. Salonen Socioeconomic Status and Progression of Carotid Atherosclerosis : Prospective Evidence From the Kuopio Ischemic Heart Disease Risk Factor Study Arterioscler Thromb Vasc Biol, March 1, 1997; 17(3): 513 - 519. [Abstract] [Full Text]
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L. Niskanen, R. Rauramaa, H. Miettinen, S. M. Haffner, M. Mercuri, and M. Uusitupa Carotid Artery Intima-Media Thickness in Elderly Patients With NIDDM and in Nondiabetic Subjects Stroke, November 1, 1996; 27(11): 1986 - 1992. [Abstract] [Full Text]
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H. V. Anderson Estrogen Therapy, Atherosclerosis, and Clinical Cardiovascular Events Circulation, October 15, 1996; 94(8): 1809 - 1811. [Full Text]
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A. A. Nabulsi, A. R. Folsom, M. Szklo, A. White, M. Higgins, and G. Heiss No Association of Menopause and Hormone Replacement Therapy With Carotid Artery Intima-Media Thickness Circulation, October 15, 1996; 94(8): 1857 - 1863. [Abstract] [Full Text]
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M. I.J. Uusitupa, L. Niskanen, J. Luoma, P. Vilja, M. Mercuri, R. Rauramaa, and S. Yla-Herttuala Autoantibodies Against Oxidized LDL Do Not Predict Atherosclerotic Vascular Disease in Non–Insulin-Dependent Diabetes Mellitus Arterioscler Thromb Vasc Biol, October 1, 1996; 16(10): 1236 - 1242. [Abstract] [Full Text]
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J. G. Terry, G. Howard, M. Mercuri, M. G. Bond, and J. R. Crouse III Apolipoprotein E Polymorphism Is Associated With Segment-Specific Extracranial Carotid Artery Intima-Media Thickening Stroke, October 1, 1996; 27(10): 1755 - 1759. [Abstract] [Full Text]
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M. Suzuki, K. Shinozaki, A. Kanazawa, Y. Hara, Y. Hattori, M. Tsushima, and Y. Harano Insulin Resistance as an Independent Risk Factor for Carotid Wall Thickening Hypertension, October 1, 1996; 28(4): 593 - 598. [Abstract] [Full Text]
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M. Suurkula, B. Fagerberg, I. Wendelhag, S. Agewall, and J. Wikstrand Atherosclerotic Disease in the Femoral Artery in Hypertensive Patients at High Cardiovascular Risk: The Value of Ultrasonographic Assessment of Intima-Media Thickness and Plaque Occurrence Arterioscler Thromb Vasc Biol, August 1, 1996; 16(8): 971 - 977. [Abstract] [Full Text]
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P. M. Okin, M. J. Roman, R. B. Devereux, and P. Kligfield Association of Carotid Atherosclerosis With Electrocardiographic Myocardial Ischemia and Left Ventricular Hypertrophy Hypertension, July 1, 1996; 28(1): 3 - 7. [Abstract] [Full Text]
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D. Baldassarre, E. Tremoli, G. Franceschini, S. Michelagnoli, and C.R. Sirtori Plasma Lipoprotein(a) Is an Independent Factor Associated With Carotid Wall Thickening in Severely but Not Moderately Hypercholesterolemic Patients Stroke, June 1, 1996; 27(6): 1044 - 1049. [Abstract] [Full Text]
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J. L. Megnien, A. Simon, M. Lemariey, M. C. Plainfosse, and J. Levenson Hypertension Promotes Coronary Calcium Deposit in Asymptomatic Men Hypertension, April 1, 1996; 27(4): 949 - 954. [Abstract] [Full Text]
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T. Uehara, M. Tabuchi, T. Hayashi, H. Kurogane, and A. Yamadori Asymptomatic Occlusive Lesions of Carotid and Intracranial Arteries in Japanese Patients With Ischemic Heart Disease : Evaluation by Brain Magnetic Resonance Angiography Stroke, March 1, 1996; 27(3): 393 - 397. [Abstract] [Full Text]
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M. Cortellaro, D. Baldassarre, E. Cofrancesco, E. Tremoli, A. Colombo, C. Boschetti, and R. Paoletti Relation Between Hemostatic Variables and Increase of Common Carotid Intima-Media Thickness in Patients With Peripheral Arterial Disease Stroke, March 1, 1996; 27(3): 450 - 454. [Abstract] [Full Text]
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M. A. Espeland, T. E. Craven, W. A. Riley, J. Corson, A. Romont, and C. D. Furberg Reliability of Longitudinal Ultrasonographic Measurements of Carotid Intimal-Medial Thicknesses Stroke, March 1, 1996; 27(3): 480 - 485. [Abstract] [Full Text]
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D. H. O'Leary, J. F. Polak, R. A. Kronmal, P. J. Savage, N. O. Borhani, S. J. Kittner, R. Tracy, J. M. Gardin, T. R. Price, and C. D. Furberg Thickening of the Carotid Wall : A Marker for Atherosclerosis in the Elderly? Stroke, February 1, 1996; 27(2): 224 - 231. [Abstract] [Full Text]
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A. Visona, R. Pesavento, L. Lusiani, A. Bonanome, C. Cernetti, M. Rossi, P. Maiolino, and A. Pagnan Intimal Medial Thickening of Common Carotid Artery as Indicator of Coronary Artery Disease Angiology, January 1, 1996; 47(1): 61 - 66. [Abstract] [PDF]
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J. R. Crouse, U. Goldbourt, G. Evans, J. Pinsky, A. R. Sharrett, P. Sorlie, W. Riley, and G. Heiss Risk Factors and Segment-Specific Carotid Arterial Enlargement in the Atherosclerosis Risk in Communities (ARIC) Cohort Stroke, January 1, 1996; 27(1): 69 - 75. [Abstract] [Full Text]
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J. R. Kaplan, M. R. Adams, M. S. Anthony, T. M. Morgan, S. B. Manuck, and T. B. Clarkson Dominant Social Status and Contraceptive Hormone Treatment Inhibit Atherogenesis in Premenopausal Monkeys Arterioscler Thromb Vasc Biol, December 1, 1995; 15(12): 2094 - 2100. [Abstract] [Full Text]
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M. R. Adams, A. Nakagomi, A. Keech, J. Robinson, R. McCredie, B. P. Bailey, S. B. Freedman, and D. S. Celermajer Carotid Intima-Media Thickness Is Only Weakly Correlated With the Extent and Severity of Coronary Artery Disease Circulation, October 15, 1995; 92(8): 2127 - 2134. [Abstract] [Full Text]
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