Revista chilena de cardiología
versión On-line ISSN 0718-8560
ACEVEDO, Mónica et al. Relation of Intima-Media Thickness, traditional Risk Factors and Metabolic Syndrome in subjects with or with inflammation. Rev Chil Cardiol [online]. 2009, vol.28, n.4, pp. 337-348. ISSN 0718-8560. doi: 10.4067/S0718-85602009000300001.
Carotid intima-media thickness (CIMT) is a marker for cerebral and coronary ischemic events. Normal values for CIMT in Chile have been published but the relation of CIMT to level of risk factors (RF) is unknown. Aim. To analyze the relation of CIMT to level of traditional RF and the presence of metabolic syndrome (MS), with or without inflammation. Methods. Males and females living in Santiago, Chile, with no prior history of ischemic events, of a low, medium or high socio-economic level, were studied. Demographic data, and presence of RF were obtained. Blood pressure, BMI, waist, blood lipids, blood glucose and US-CRP were measured in the fasting state. The presence of MS was defined by the NCEP-ATP III (2001) critería. Inflammation was defined as US-CRP >2mg/L (the cutoff point for increased risk, according to the AHA). CIMT was measure in both carotid arteries using the MATH® software. Results. 999 subjects (508 males), aged 43 ± 11 years old. The prevalence of hypertension (HT) was 30%, dyslipidemia 68%, tobáceo use 41% and MS 24%. Mean CIMT was 0.61 ±0.1 mm and US-PCR was 2.22 mg/L. CIMT according to number of RF - age > 45/55 (male/female), diabetes, HT, total cholesterol > 200 mg/dl, HDL < 40/50 mg/dl, tobacco use and family history- were: 0 RF: 0.55 ± 0.08; 1-2 RF: 0.59 ± 0.091; ≥3 RF: 0.67 ± 0.12 (p < 0.0001). CIMT according to Framingham scores was: < 5%: 0.58 ± 0.09; 5 - 10%: 0.66 ± 0.11; 10 - 20%: 0.68 ±0.11 and > 20%: 0.76 ± 0.14 (p < 0.0001). CIMT was significantly greater in subjects with MS and more in the group with US-PCR > 2mg/L. In múltiple regression analysis, CIMT was jointly associated to Framingham score (p < 0.0001) and presence of MS + US-PCR >2 mg/L (p=0.01) (r2=0.19 for the model). Conclusion. CIMT increases in relation to traditional RF load and the presence of MS. An increased atherosclerotic risk in subjects with MS+inflammation (US-PCR > 2 mg/L) should be confirmed by follow up studies of cardiovascular events. This study confirms the clínical value of CIMT measurement as and indication of RFIoad.
Palabras clave : Carotid intima-media thickness; cardiovascular risk factors.