Comparison of the Relation of Carotid Intima-Media Thickness with Incident Heart Failure with Reduced Versus Preserved Ejection Fraction (From the Multi-Ethnic Study of Atherosclerosis [MESA]).

Like Comment
Increased carotid intima-media thickness (cIMT) is associated with heart failure (HF) in previous studies, but it is not known whether the association of cIMT differs between HF with reduced (HFrEF) versus preserved ejection fraction (HFpEF). We studied 6699 participants (mean age 62 ± 10 years, 47% male, and 38% white) from the Multi-Ethnic Study of Atherosclerosis (MESA) with baseline cIMT measurements. We classified HF events as HFrEF (EF <50%) or HFpEF (EF ≥ 50%) at the time of diagnosis. Cox proportional hazard regression was used to compute hazard ratios (HR), and 95% confidence intervals (CI) for the association between the IMT Z-score (measured maximum IMT of Internal Carotid (IC) and Common Carotid (CC) sites as the mean of the maximum IMT of the near and far walls of right and left sides), and incident HFrEF or HFpEF. Models were adjusted for covariates and interim coronary artery disease (CAD) events. A total of 191 HFrEF and 167 HFpEF events occurred during follow-up. In multivariable analysis, each 1 standard deviation increase in the measured maximum IMT (Z-score) was associated with both HFrEF and HFpEF in the unadjusted and demographically adjusted models [HR, 95% CI 1.57 (1.43-1.73)] and [HR, 95% CI 1.61 (1.47-1.77)] but not in the fully adjusted models [HR, 95% CI 1.11 (0.96-1.28)] and [HR, 95% CI 1.13 (0.98-1.30)]. In conclusion, cIMT was significantly associated with incident HF, but the association is partially attenuated with adjustment for demographic factors and becomes non-significant after adjustment for other traditional heart failure risk factors and interim CAD events. There was no difference in the association of IMT measures with HFrEF versus HFpEF.


View the full article @ The American Journal of Cardiology


Get PDF with LibKey
Authors: Amer I Aladin, Elsayed Z Soliman, Dalane W Kitzman, Zeina Dardari, Shereen H Rasool, Joseph Yeboah, Matthew J Budoff, Bruce M Psaty, Pamela Ouyang, Joseph F Polak, Roger S Blumenthal, John W McEvoy, Sanjay K Gandhi, David M Herrington

ClinOwl

The wider, wiser view for healthcare professionals. ClinOwl signposts the latest clinical content from over 100 leading medical journals.
6584 Contributions
2 Followers
0 Following