Abstract

CAROTID INTIMA-MEDIA THICKNESS IN PATIENTS PRESENTING WITH ACUTE MYOCARDIAL INFARCTION

Murari Prasad Barakoti*, Ratna Raj Poudyal, Ram Kumar Ghimire, Sunil Chandra Jha and Sadip Panta

ABSTRACT

Aim: To assess the role of carotid intima-media thickness in patients with acute myocardial infarction as compared to without it. Methods: It’s a prospective case control study in 50 patients with acute myocardial infarction defined as clinical presentation of acute coronary syndrome and elevated Troponin I and data was compared with 54 age and sex matched control subjects. All patients had their carotid intimamedia thickness measured within 1 cm from carotid bulb in the common carotid artery on both sides, and average and maximum values were calculated from at least 3 measurements on each side. The measured values were compared with ARIC (Atherosclerosis Risk in Communities; a large epidemiological study) values for the appropriate age categories. Result: Eight percent of MI had occurred below age 45 years. Twenty six (52%) cases and 18 (33%) of control subjects were hypertensive. Eighteen percent of cases and 4% of control had diabetes. More than 50% of total patients were past or current smokers. Fifty one percent of cases had non-ST elevation MI and 27% had inferior wall STEMI. Mean CIMT in MI group was 0.69±0.19 mm and 0.74±0.19mm in right and left side and in control group was 0.61±0.18 mm and 0.59±0.19 mm in right and left side respectively ( P = 0.037 for right CCA CIMT, P= 0.0001 for left CCA CIMT). The number of patients with CIMT value above the 75th percentile value of ARIC were 24 in cases and 15 in control in right side (P=0.03) and 24 in cases and 10 in control in left side (P=0.001). Conclusion: Increased value of CIMT is significantly associated with incident MI. The easy, cheap and non-invasive test can be used as surrogate marker of atherosclerosis.

Keywords: Atherosclerosis; carotid intima-media thickness; myocardial infarction; Nepal; common carotid artery; coronary artery disease.