Increased carotid intima-media thickness and low ankle brachial index in patients after acute myocardial infarction

Abstract

Background: Increased intima-media thickness (IMT) of the carotid arteries and the ankle–brachial pressure index (ABI) are generally considered an early marker of atherosclerosis. The aim of this study was to assess the frequency of subjects with low ABI and an increased IMT as markers of atherosclerosis in a group of patients after myocardial infarction.

Methods: The test group included 50 patients after myocardial infarction (AMI), 32 males and 18 females aged between 38 and 78 years. The control group consisted of 50 subjects without ischaemic heart disease, who were comparable to the test group by age, gender and place of residence. High-resolution ultrasonography for the non-invasive measurement of IMT on the far wall at three different sites of the carotid arteries (the common carotid artery, carotid bifurcation, and internal carotid artery) has been used. Peripheral arterial disease (PAD) was diagnosed in the lower extremities by means of Doppler ultrasound (ABI </= 0.9).

Results: The patients after myocardial infarction (IMT = median 0.85, interquartile range 0.72–0.95) compared to the subjects in the control group (IMT = 0.74, IQR 0.67–0.86) had significantly increased IMT (p < 0.05). The group of patients with AMI and PAD had significantly higher IMT, 0.93(0.86–1.03) in comparison with the group of patients with AMI and without PAD, 0.73(0.65–0.84) p < 0.001. The difference in IMT between patients with ST-elevation AMI (STEMI), 0.84 (0.70–0.96) and patients with non-ST-elevation AMI (NSTEMI), 0.89 (0.79–0.95) was not significant. The peripheral arterial disease was diagnosed in 24 (48 %) of patients after myocardial infarction and in 10 (20 %) of the control group (p < 0.05).

Conclusion: Our study has demonstrated that increased carotid IMT and PAD are frequently present in patients after myocardial infarction. The subjects of the test and control group had an increased IMT and asymptomatic PAD.