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Second Congress of Cardiology and Angiology of Bosnia & Herzegovina

 

MULTIFOCAL ATHEROSCLEROTIC DISEASE AND ITS CORRELATION WITH CORONARY HEART DISEASE
M. Dilić 1, S.Pehar 1, E.Raljević 2 and M.Kulić 3
Institute of Vascular Diseases 1, Clinic of Cardiology 2 Clinic of Cardiosurgery 3, Clinical Center University of Sarajevo, Bosnia and Herzegovina

Background: High resolution ultrasound B-mode is increasingly used in detection and measuring of atherosclerotic changes. Intima-media thickness (IMT) is used as a marker of systemic atherosclerosis especially measured on carotid arteries. There are very few studies correlated IMT of carotid, brachial and femora arteries with multiple risk factors (MRF) and influence of this correlation to atherosclerotic events. As a part of Sarajevo Vascular Study (SVS), with total of 1680 patients, with peripheral vascular diseases (PVD), cerebrovascular diseases (CVD), and coronary heart disease (CHD), we performed correlation of multifocal atherosclerotic disease and CHD.
Aim - to investigate a possible relationship between IMT of common carotid artery (CCA), brachial artery (BrA) and femoral superficial artery (FSA) with coronary artery disease, and to correlate IMT with multiple risk factors (MRF) score.
Method:
in this part od SVS, we included total of 254 patients (pts), divided in three groups, group 1, CHD patients, (n-119, 93 males and 26 females, age 65 ± 8 years), group 2, non-CHD patients, (n-85, 60 males and 25 females, age 68 ± 7), all were without coronary heart disease, but with at least 3/7 MRF , and controls, (n-50, 35 males and 15 females, age 65 ±10), without any atherosclerotic disease, with less than 3/7 MRF. MRF variables were, (MRF score - x/7), - age, gender, hypertension, hyperlipidemia, tobacco, BMI, and diabetes. We measured IMT abd lumen diameters at the distal portion of CCA, proximal portion of FSA, and mid portion of BrA. Follow up period was 36 months.
Results: mean value of CCA IMT was 1,15 0,4 mm, and of BrA IMT 0,62 0,18 mm. Mean values of CCA IMT and BrA IMT in CHD patients were significantly higher than in controls, p<0,0001. Correlation Spearman Rank Test has positive and sensitive rank with BrA and CCA IMT and CHD, r=0,56, p<0,01. Rank value in FSA was of borderline significance, p<0,04. IMT value has a significance with outcome of CHD. MRF score correlate with IMT value. In overall group full control of MRF (tobacco, hyperlipidemia and BMI) results in significant reduction of IMT (p<0,01) and significant reduction of new CHD events (p<0,02).
Conclusion: we had a positive correlation of changes in CCA and BrA with CHD events and MRF score. Full control of three MRF (tobacco, hyperlipidemia, and BMI), significantly reduces CHD events.

Keywords: atherosclerosis, multifocal, coronary artery disease, multiple risk factors

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