Common carotid artery intima-media thickness its correlation with atherosclerotic cardiovascular events in patients with type 2 diabetes mellitus

Abstract EN

Vascular complications are a major cause of morbidity and mortality in patients with diabetes mellitus and affect the quality of life of these patients.

Atherosclerosis, which is the major underlying risk factor, is accelerated in diabetes.

To reduce morbidity and mortality, identification of patients with high risk for development of vascular events is necessary.

Apart from other risk prediction models, detection of sub clinical atherosclerosis at common carotid site by B-mode ultrasonography is a reliable method, can add to the benefit of and improve risk prediction.

Population based studies have revealed that increased common carotid media thickness (CCIMT) is associated with prevalent coronary artery disease and is a surrogate maker of cardiovascular events.

To evaluate whether increased CCIMT is associated with increased risk of cardiovascular events in patients with type 2 diabetes.

A total of 90 patients with type 2 diabetes, who were included in the study, were divided in two groups : group (1) without vascular events, and group (2) with vascular events.

Apart from patients demographics, detailed history of events physical examination, through blood analysis for fasting, post prandial blood sugar, serum cholesterol, TG, renal function test, chest X-ray, and ECG were recorded.

CCIMT was measured by B-mode ultrasonography, using high frequency (9 MHz) linear probe by standard protocol as described in the literature.

Mean of three recordings on each side were used for statistical analysis.

Our results showed that, of the 90 patients studied, 45 diabetes mellitus (DM) patients had atherosclerotic events and significantly higher CCIMT values (mean value of 1.005 + 0.17mm), whereas 45 comparable DM patients, without atherosclerotic events, had lower CCIMT values (0.798 + 12.0 mm) (p < 0.0001).

A higher CCIMT value ( >0.9mm) had a statistically significant association with high odds ratios for atherosclerotic events like ischemic heart disease, cerebrovascular accident, and peripheral vascular disease.

Type 2 DM patients, with atherosclerotic events, had significantly higher CCIMT values than those without vascular events.

Patients with higher values of CCIMT had high odds ratio for vascular events.

Assessment of CCIMT should be done to enable prompt and prudent preventive action in type 2 diabetes patients well before and atherosclerotic event occurs.