Rapp-Bernhardt Ulrike MD, Presenter: Nothing to Disclose

Thomas M. Bernhardt MD, Abstract Co-Author: Nothing to Disclose

Roman M. Fischbach MD, Abstract Co-Author: Nothing to Disclose

Kai U. Juergens MD, Abstract Co-Author: Nothing to Disclose

Eva Maria Fallenberg MD, Abstract Co-Author: Nothing to Disclose

Walter Leonhard Heindel MD, Abstract Co-Author: Nothing to Disclose

To evaluate intima media thickness (IMT) as morphologic and endothelial function as functional change of artherosclerosis and their relationship to risk of coronary artery disease (CAD) in asymptomatic men with risk factors related to the highest quintile of PROCAM (Proscpective Cardiovascular Muenster Study).

A 10-year follow-up of middle-aged men led to the identification of eight independent risk variables which contribute to CAD. An algorithm based on these risk factors may be used to calculate an individual`s risk of myocardial infarction. However, more than two-third of subjects with a high individual risk will not suffer from myocardial infarction. Therefore, non-invasive risk factors have to be tested to achieve further differentiation of these asymptomatic subjects. 103 male subjects with high risk of CAD and 20 male control subjects aged 57.7 ± 5.1 years were enrolled from the PROCAM study. They underwent B-mode carotid ultrasound (12 MHz, Sonoline Elegra, Siemens inc.) to determine the mean of 18 measurements of IMT of anterior, lateral, posterior wall of common carotid artery proximal to the bifurcation. Hemodynamic forearm investigation was performed to asses the endothelial dependent (ischemic induced) and independent vasodilation (0.4 mg glyceroltrinitrat sublingual). IMT and vasodilation were compared with the PROCAM risk algorithm. Analysis was performed using statistical package of the social sciences (SPSS) and Mann-Whitney test for significance level.

IMT was significantly associated with age (p = 0.02) and smoking (p = 0.03) as independent variables of PROCAM risk algorithm. IMT showed a positive but no significant correlation with PROCAM risk algorithm (p = 0.26). The results of endothelial dependent as well as independent vasodilation and PROCAM risk algorithm were not significant (p = 0.37; p = 0.52).

These non-invasive technologies fail to accurately reflect risk of CAD in this high risk population.

Ulrike, R, Bernhardt, T, Fischbach, R, Juergens, K, Fallenberg, E, Heindel, W, Relation of Carotid Intima-media Thickness, Endothelial Function, and Cardiovascular Risk Factors in an Asymptomatic High-Risk Population for Coronary Artery Disease.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4409897.html