Carotid intima-media thickness of young coronary patients

BACKGROUND: Although a greater than normal intima-media thickness (IMT) has been found in older coronary patients, the data for younger patients are lacking. OBJECTIVE: To determine the carotid IMT in patients with premature myocardial infarction. METHODS: We measured IMT (common and internal carotid, carotid bifurcation) in 30 coronary patients, aged 30-50 years (mean 46 years), who had survived myocardial infarctions 1-9 years (mean 6 years) earlier, and in 30 age-matched men without clinically evident coronary heart disease (controls) by B-mode ultrasonography. Blood levels of lipoproteins, glucose, iron and transferrin, fibrinogen, tissue plasminogen activator (t-PA) antigen level and activity and plasminogen activator inhibitor (PAI-1) antigen level and activity were also determined. RESULTS: IMT in all segments of carotid arteries in the patients was significantly greater than that in the controls (P < 0.0001). The presence of atherosclerotic plaques was correlated to greater than normal carotid IMT. Other risk factors displaying statistically significant correlations to mean carotid IMT were t-PA antigen level and activity, PAI-1 antigen level and level of high-density lipoprotein cholesterol. CONCLUSIONS: The significant association between carotid IMT and coronary heart disease suggests that carotid and coronary atherosclerosis evolve simultaneously. Hence carotid IMT can be used as a predictor of coronary atherosclerosis.