Common Carotid Intimal-medial Thickness is associated with Coronary In-Stent Restenosis

Abstract

Introduction

Coronary artery in-stent restenosis (ISR) consists of a rapid vascular smooth muscle cell proliferation after stent placement. This study tested the hypothesis that carotid artery intimal thickening may be associated with susceptibility to coronary ISR.

Methods

Coronary stent treated patients with (ISR, n = 81) and without (ISR-free, n = 163) ISR were examined along with age- and gender-matched vascular disease-free controls (n = 200). All participants underwent bilateral carotid duplex ultrasound assessment and cardiovascular risk factor evaluation. Multiple logistic regressions were used to determine the independence of any risk associations with either coronary artery disease or ISR.

Results

Maximal carotid intimal medial thickness was independently associated with symptomatic coronary ISR, with an adjusted odds ratio of 3.4 (95% confidence interval, 1.5–7.7, p < 0.005 for carotid intimal medial thickness >1 mm). Atherosclerosis within the carotid bifurcation and internal carotid artery, as measured by carotid stenosis scores, was significantly greater in both coronary artery patient groups compared with vascular disease-free controls but was not associated with ISR.

Conclusions

Intimal thickening within the common carotid artery may represent a distinct pathological process from that which occurs within the carotid bifurcation and internal carotid arteries. Changes in common carotid IMT appears to represent an independent risk indicator for symptomatic coronary ISR.