Carotid atherosclerosis and risk of subsequent coronary event in outpatients with atherothrombosis

Gaia Sirimarco, Pierre Amarenco, Julien Labreuche, Pierre Jean Touboul, Mark Alberts, Shinya Goto, Joachim Rother, Jean Louis Mas, Deepak L. Bhatt, Philippe Gabriel Steg

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

BACKGROUND AND PURPOSE - : The presence of carotid plaque reflects overall atherosclerotic burden and may predict coronary artery disease events. We examined the association among carotid atherosclerosis, history of atherothrombotic events, and risk of coronary events. METHODS - : Among 45 227 patients in the Reduction of Atherothrombosis for Continued Health (REACH) Registry with 4-year follow-up, 23 364 patients with information on carotid atherosclerosis at baseline were analyzed. The primary outcome was the composite of first occurrence of cardiovascular death, myocardial infarction, or coronary hospitalization. RESULTS - : The carotid atherosclerosis was present in 46% of patients (n=10 725) and was associated with increasing conventional cardiovascular risk factors and extent of symptomatic vascular disease. During 4-year follow-up, 4304 patients experienced ≥1 coronary event. After adjustment for cardiovascular risk factors and geographic region, the risk of coronary events increased by 22% (95% confidence interval [CI], 14%-30%) in patients with versus without carotid atherosclerosis. The relative increase was 18% (95% CI, -7%-51%) in patients enrolled with multiple risk factors only, 25% (95% CI,16%-35%) in patients with coronary artery disease, 46% (95% CI,28%-65%) in patients with cerebrovascular disease, and 37% (95% CI,17%-60%) in patients with peripheral artery disease. Carotid atherosclerosis was associated with increased risk, even among patients with previous myocardial infarction but no known stroke (P=0.001) or among patients with previous stroke but no known myocardial infarction (P<0.001). CONCLUSIONS - : Carotid atherosclerosis was an independent predictor of coronary events across all types of symptomatic vascular disease and had an incremental effect on risk regardless of risk factors or location of vessel disease.

Original languageEnglish (US)
Pages (from-to)373-379
Number of pages7
JournalStroke
Volume44
Issue number2
DOIs
StatePublished - Feb 2013

Fingerprint

Carotid Artery Diseases
Outpatients
Confidence Intervals
Myocardial Infarction
Vascular Diseases
Coronary Artery Disease
Stroke
Cerebrovascular Disorders
Peripheral Arterial Disease
Registries
Hospitalization

Keywords

  • atherosclerosis
  • carotid plaque
  • coronary disease

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Clinical Neurology
  • Advanced and Specialized Nursing

Cite this

Sirimarco, G., Amarenco, P., Labreuche, J., Touboul, P. J., Alberts, M., Goto, S., ... Steg, P. G. (2013). Carotid atherosclerosis and risk of subsequent coronary event in outpatients with atherothrombosis. Stroke, 44(2), 373-379. https://doi.org/10.1161/STROKEAHA.112.673129

Carotid atherosclerosis and risk of subsequent coronary event in outpatients with atherothrombosis. / Sirimarco, Gaia; Amarenco, Pierre; Labreuche, Julien; Touboul, Pierre Jean; Alberts, Mark; Goto, Shinya; Rother, Joachim; Mas, Jean Louis; Bhatt, Deepak L.; Steg, Philippe Gabriel.

In: Stroke, Vol. 44, No. 2, 02.2013, p. 373-379.

Research output: Contribution to journalArticle

Sirimarco, G, Amarenco, P, Labreuche, J, Touboul, PJ, Alberts, M, Goto, S, Rother, J, Mas, JL, Bhatt, DL & Steg, PG 2013, 'Carotid atherosclerosis and risk of subsequent coronary event in outpatients with atherothrombosis', Stroke, vol. 44, no. 2, pp. 373-379. https://doi.org/10.1161/STROKEAHA.112.673129
Sirimarco, Gaia ; Amarenco, Pierre ; Labreuche, Julien ; Touboul, Pierre Jean ; Alberts, Mark ; Goto, Shinya ; Rother, Joachim ; Mas, Jean Louis ; Bhatt, Deepak L. ; Steg, Philippe Gabriel. / Carotid atherosclerosis and risk of subsequent coronary event in outpatients with atherothrombosis. In: Stroke. 2013 ; Vol. 44, No. 2. pp. 373-379.
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abstract = "BACKGROUND AND PURPOSE - : The presence of carotid plaque reflects overall atherosclerotic burden and may predict coronary artery disease events. We examined the association among carotid atherosclerosis, history of atherothrombotic events, and risk of coronary events. METHODS - : Among 45 227 patients in the Reduction of Atherothrombosis for Continued Health (REACH) Registry with 4-year follow-up, 23 364 patients with information on carotid atherosclerosis at baseline were analyzed. The primary outcome was the composite of first occurrence of cardiovascular death, myocardial infarction, or coronary hospitalization. RESULTS - : The carotid atherosclerosis was present in 46{\%} of patients (n=10 725) and was associated with increasing conventional cardiovascular risk factors and extent of symptomatic vascular disease. During 4-year follow-up, 4304 patients experienced ≥1 coronary event. After adjustment for cardiovascular risk factors and geographic region, the risk of coronary events increased by 22{\%} (95{\%} confidence interval [CI], 14{\%}-30{\%}) in patients with versus without carotid atherosclerosis. The relative increase was 18{\%} (95{\%} CI, -7{\%}-51{\%}) in patients enrolled with multiple risk factors only, 25{\%} (95{\%} CI,16{\%}-35{\%}) in patients with coronary artery disease, 46{\%} (95{\%} CI,28{\%}-65{\%}) in patients with cerebrovascular disease, and 37{\%} (95{\%} CI,17{\%}-60{\%}) in patients with peripheral artery disease. Carotid atherosclerosis was associated with increased risk, even among patients with previous myocardial infarction but no known stroke (P=0.001) or among patients with previous stroke but no known myocardial infarction (P<0.001). CONCLUSIONS - : Carotid atherosclerosis was an independent predictor of coronary events across all types of symptomatic vascular disease and had an incremental effect on risk regardless of risk factors or location of vessel disease.",
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AU - Alberts, Mark

AU - Goto, Shinya

AU - Rother, Joachim

AU - Mas, Jean Louis

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N2 - BACKGROUND AND PURPOSE - : The presence of carotid plaque reflects overall atherosclerotic burden and may predict coronary artery disease events. We examined the association among carotid atherosclerosis, history of atherothrombotic events, and risk of coronary events. METHODS - : Among 45 227 patients in the Reduction of Atherothrombosis for Continued Health (REACH) Registry with 4-year follow-up, 23 364 patients with information on carotid atherosclerosis at baseline were analyzed. The primary outcome was the composite of first occurrence of cardiovascular death, myocardial infarction, or coronary hospitalization. RESULTS - : The carotid atherosclerosis was present in 46% of patients (n=10 725) and was associated with increasing conventional cardiovascular risk factors and extent of symptomatic vascular disease. During 4-year follow-up, 4304 patients experienced ≥1 coronary event. After adjustment for cardiovascular risk factors and geographic region, the risk of coronary events increased by 22% (95% confidence interval [CI], 14%-30%) in patients with versus without carotid atherosclerosis. The relative increase was 18% (95% CI, -7%-51%) in patients enrolled with multiple risk factors only, 25% (95% CI,16%-35%) in patients with coronary artery disease, 46% (95% CI,28%-65%) in patients with cerebrovascular disease, and 37% (95% CI,17%-60%) in patients with peripheral artery disease. Carotid atherosclerosis was associated with increased risk, even among patients with previous myocardial infarction but no known stroke (P=0.001) or among patients with previous stroke but no known myocardial infarction (P<0.001). CONCLUSIONS - : Carotid atherosclerosis was an independent predictor of coronary events across all types of symptomatic vascular disease and had an incremental effect on risk regardless of risk factors or location of vessel disease.

AB - BACKGROUND AND PURPOSE - : The presence of carotid plaque reflects overall atherosclerotic burden and may predict coronary artery disease events. We examined the association among carotid atherosclerosis, history of atherothrombotic events, and risk of coronary events. METHODS - : Among 45 227 patients in the Reduction of Atherothrombosis for Continued Health (REACH) Registry with 4-year follow-up, 23 364 patients with information on carotid atherosclerosis at baseline were analyzed. The primary outcome was the composite of first occurrence of cardiovascular death, myocardial infarction, or coronary hospitalization. RESULTS - : The carotid atherosclerosis was present in 46% of patients (n=10 725) and was associated with increasing conventional cardiovascular risk factors and extent of symptomatic vascular disease. During 4-year follow-up, 4304 patients experienced ≥1 coronary event. After adjustment for cardiovascular risk factors and geographic region, the risk of coronary events increased by 22% (95% confidence interval [CI], 14%-30%) in patients with versus without carotid atherosclerosis. The relative increase was 18% (95% CI, -7%-51%) in patients enrolled with multiple risk factors only, 25% (95% CI,16%-35%) in patients with coronary artery disease, 46% (95% CI,28%-65%) in patients with cerebrovascular disease, and 37% (95% CI,17%-60%) in patients with peripheral artery disease. Carotid atherosclerosis was associated with increased risk, even among patients with previous myocardial infarction but no known stroke (P=0.001) or among patients with previous stroke but no known myocardial infarction (P<0.001). CONCLUSIONS - : Carotid atherosclerosis was an independent predictor of coronary events across all types of symptomatic vascular disease and had an incremental effect on risk regardless of risk factors or location of vessel disease.

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