Common carotid artery diameter as a promising new candidate marker of cardiovascular risk in the IMPROVE study cohort

Aim: To explore whether inter-adventitial common carotid artery diameter (CCAD) detected by B-mode ultrasound may be considered a candidate marker of cardiovascular risk. Methods: The baseline data of the IMPROVE study cohort, including 1776 men and 1935 women representative of an European population at high risk of cardiovascular diseases, were analysed to explore whether CCAD is associated with the extent of carotid atherosclerosis, independently of traditional vascular risk factors and anthropometric variables. Results: After adjustment for possible confounders (height, centre, reader and sonographer), CCAD was positively associated with male gender, age, weight, body mass index, waist, hip, waist/hip ratio, systolic and diastolic blood pressure, pulse pressure, triglycerides, blood glucose, uric acid, cigarette packyears and family history of peripheral vascular disease (all p<0.0001). In contrast, years elapsed since smoking cessation, total-, HDL- and LDL-cholesterol were negatively related to CCAD (all p<0.0001). In the full model adjusted for all these confounders, CCAD was positively associated with carotid wall thickness (p<0.0001 for both IMTmean and IMTmax) and with the prevalence of carotid segments with plaques (p<0.04). Conclusion: Inter-adventitial CCAD is positively associated with carotid atherosclerosis and with most vascular risk factors. These results suggest that CCAD is a promising candidate marker of cardiovascular risk. Completion of the IMPROVE study will allow to assess prospectively the value of CCAD to predict new vascular events, independently to VRFs and carotid IMT. Funding: European Project, IMPROVE QLG1-CT-2002-00896