The role of carotid arterial intima media thickness in predicting acute coronary syndrome. A prospective study in a Romanian County Hospital

Background: Intima-media thickness (IMT) has been linked to cardiovascular disease. We have evaluated the relationship between IMT and ACS in a group of patients with degenerative aortic stenosis. Methods: Our study cohort consisted of 196 consecutive Caucasian patients, aged 56-94, with degenerative aortic stenosis, who were free of clinic ischemic heart disease. Patients underwent standardized clinical, echocardiographic, carotid artery ultrasound and laboratory evaluation and the incidence of ACS was ascertained using validated methods. Results: During a median follow up of 3 years, 54 ACS's occurred (27.6%) and IMT was documented in 47 patients (87%) compared to 96 (67.6%) in the witness group. The presence of IMT>1 increases the risk of appearance of ACS 3.2 times, which has statistical significance (OR 3.2173; 95% CI 1.3501-7.666; p=0.0084). Conclusions: The patients with aortic degenerative stenosis associated with intima media thickness present a high risk of developing ACS.