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| ICA restrictive index predicts cardiovascular events |
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02 February 2006
The haemodynamic restrictive index (RI) of the internal carotid artery (ICA) predicts cardiovascular mortality and morbidity as accurately as the intima-media thickness (IMT) of the common carotid artery (CCA), say Swiss researchers "In clinical practice, this means that patients with risk constellations or mild first complications of arteriosclerosis can in future be identified as low-risk patients by means of a simple RI measurement." Dr Daniel Staub (Cantonal Hospital, Frauenfeld, Switzerland) and colleagues measured IMT and RI in the CCA and ICA of 146 patients with arteriosclerosis or other cardiovascular risk factors.
During a median follow-up of 36 months, 39 cardiovascular events occurred in 28 patients, including eight ischaemic strokes and seven transient ischaemic attacks in 10 patients, and one death attributable to a stroke. The cardiovascular event rate was 25.6% in patients with an IMT of 0.79 mm or greater, compared with 11.8% in those who had a smaller IMT, while the event rates were 25% and 12.7% in patients with a RI of the ICA of 0.66 or higher, or less than 0.66, respectively. The risk of a cardiovascular event was elevated 1.53-fold for each 1 standard deviation (SD) increase in IMT of the CCA and 1.91-fold for each 1-SD rise in RI of the ICA.
"RI measurements are easier to assess and will therefore have a higher acceptance for clinical practice than the more complex IMT measurements," the scientists conclude. "The rather poorer correlation of IMT with clinical end points compared with RI ICA is another argument for introducing RI ICA as a screening parameter."
Reference:
Stroke 2006; online publication.
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