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HERO ID
156129
Reference Type
Journal Article
Title
Predictive value of noninvasive measures of atherosclerosis for incident myocardial infarction: the Rotterdam Study
Author(s)
van der Meer, IM; Bots, ML; Hofman, A; del Sol, AI; van der Kuip, DA; Witteman, JC
Year
2004
Is Peer Reviewed?
Yes
Journal
Circulation
ISSN:
0009-7322
EISSN:
1524-4539
Volume
109
Issue
9
Page Numbers
1089-1094
DOI
10.1161/01.CIR.0000120708.59903.1B
Web of Science Id
WOS:000220083100007
Abstract
Background - Several noninvasive methods are available to investigate the severity of extracoronary atherosclerotic disease. No population- based study has yet examined whether differences exist between these measures with regard to their predictive value for myocardial infarction (MI) or whether a given measure of atherosclerosis has predictive value independently of the other measures.
Methods and Results - At the baseline ( 1990 - 1993) examination of the Rotterdam Study, a population- based cohort study among subjects age greater than or equal to 55 years, carotid plaques and intima-media thickness (IMT) were measured by ultrasound, abdominal aortic atherosclerosis by x-ray, and lower-extremity atherosclerosis by computation of the ankle-arm index. In the present study, 6389 subjects were included; 258 cases of incident MI occurred before January 1, 2000. All 4 measures of atherosclerosis were good predictors of MI independently of traditional cardiovascular risk factors. Hazard ratios were equally high for carotid plaques (1.83 [ 1.27 to 2.62], severe versus no atherosclerosis), carotid IMT (1.95 [1.19 to 3.19]), and aortic atherosclerosis (1.94 [1.30 to 2.90]) and slightly lower for lower-extremity atherosclerosis (1.59 [1.05 to 2.39]), although differences were small. The hazard ratio for MI for subjects with severe atherosclerosis according to a composite atherosclerosis score was 2.77 (1.70 to 4.52) compared with subjects with no atherosclerosis. The predictive value of MI for a given measure of atherosclerosis was independent of the other atherosclerosis measures.
Conclusions - Noninvasive measures of extracoronary atherosclerosis are strong predictors of MI. The relatively crude measures directly assessing plaques in the carotid artery and abdominal aorta predict MI equally well as the more precisely measured carotid IMT.
Keywords
atherosclerosis; coronary disease; epidemiology
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