RESUMO
BACKGROUND@#Cardiovascular risk remains increased despite optimal low density lipoprotein cholesterol (LDL-C) level induced by intensive statin therapy. Therefore, recent guidelines recommend non-high density lipoprotein cholesterol (non-HDL-C) as a secondary target for preventing cardiovascular events. The aim of this study was to assess the efficacy and tolerability of omega-3 fatty acids (OM3-FAs) in combination with atorvastatin compared to atorvastatin alone in patients with mixed dyslipidemia.@*METHODS@#This randomized, double-blind, placebo-controlled, parallel-group, and phase III multicenter study included adults with fasting triglyceride (TG) levels ≥200 and <500 mg/dL and LDL-C levels <110 mg/dL. Eligible subjects were randomized to ATOMEGA (OM3-FAs 4,000 mg plus atorvastatin calcium 20 mg) or atorvastatin 20 mg plus placebo groups. The primary efficacy endpoints were the percent changes in TG and non-HDL-C levels from baseline at the end of treatment.@*RESULTS@#After 8 weeks of treatment, the percent changes from baseline in TG (−29.8% vs. 3.6%, P<0.001) and non-HDL-C (−10.1% vs. 4.9%, P<0.001) levels were significantly greater in the ATOMEGA group (n=97) than in the atorvastatin group (n=103). Moreover, the proportion of total subjects reaching TG target of <200 mg/dL in the ATOMEGA group was significantly higher than that in the atorvastatin group (62.9% vs. 22.3%, P<0.001). The incidence of adverse events did not differ between the two groups.@*CONCLUSION@#The addition of OM3-FAs to atorvastatin improved TG and non-HDL-C levels to a significant extent compared to atorvastatin alone in subjects with residual hypertriglyceridemia.
RESUMO
We report a case of Spontaneous coronary artery dissection associated with fragile X syndrome. The relationship between fragile X syndrome and Spontaneous coronary artery dissection is unclear. However, More research will need about the causes and treatment of Spontaneous coronary artery dissection.
Assuntos
Feminino , Humanos , Síndrome Coronariana Aguda , Vasos Coronários , Síndrome do Cromossomo X FrágilRESUMO
BACKGROUND: The purpose of this study was to evaluate whether performing an assessment of myocardial deformation using speckle tracking imaging during the recovery period after dobutamine stress echocardiography (DSE) allows detection of significant coronary artery disease (CAD) in patients with chest discomfort. METHODS: DSE and coronary angiography were performed in 44 patients with chest discomfort. The mean global longitudinal peak systolic strain (GLS) was measured at rest, at low stress (dobutamine infusion rate of 10 microg/kg/min) and at recovery (5 min after cessation of dobutamine infusion) of DSE using automated function imaging with apical views. Fractional flow reserve (FFR) was also performed in patients with intermediate coronary stenosis. CAD was defined as having a > or = 70% diameter stenosis on coronary angiography or as having a FFR < 0.8. Patients were divided two groups based on the absence or presence of CAD [CAD (-) group vs. CAD (+) group]. RESULTS: There were no significant differences in the clinical characteristics and results of conventional echocardiography between the two groups. GLS at recovery was lower in the CAD (+) group than in the CAD (-) group (-18.0 +/- 3.4% vs. -21.0 +/- 1.9%, p = 0.003). The optimal cutoff of GLS at recovery for detection of CAD was -19% (sensitivity of 70.6%, specificity of 83.3%). CONCLUSION: Assessment of GLS at recovery of DSE is a reliable and objective method for detection of CAD. This finding may suggest that systolic myocardial stunning remains even after recovery of wall motion abnormalities in patients with CAD.
Assuntos
Humanos , Constrição Patológica , Angiografia Coronária , Doença da Artéria Coronariana , Estenose Coronária , Dobutamina , Ecocardiografia , Ecocardiografia sob Estresse , Miocárdio Atordoado , Sensibilidade e Especificidade , TóraxRESUMO
BACKGROUND: Valsartan is an angiotensin II receptor blocker and is used for patient with hypertension. Although response to valsartan varies each individual, there is no study about factors affecting the variability of valsartan response. METHODS: To investigate the effects of valsartan on the baseline characteristics of blood pressure, single group, open label, pre- and post-comparison clinical study was conducted. Total 21 male Korean volunteers were enrolled. Each subject was administered no drugs in first period and valsartan 80 mg (Diovan HCT) in second period. For pharmacodynamic analysis, 24 hours blood pressure changes were monitored by ambulatory blood pressure monitoring. Twenty-four hour blood pressure changes were matched to valsartan concentration and analyzed by correlation analysis. Changes in blood pressure pattern were also analyzed. Subjects were divided into responder, non-responder, and reverse responder according to pre- and post- 24 hours blood monitoring results. For determination of pharmacokinetic parameters, plasma concentration of valsartan was measured by a validated ultra-performance liquid chromatography-tandem mass spectrometry method. Pharmacokinetic parameters including area under the plasma concentration versus time curve from 0 hour to the last measurable concentration (AUCt), area under the plasma concentration versus time curve extrapolated to infinity, maximum plasma concentration (Cmax), and time required to reach maximum plasma concentration (Tmax) were calculated by noncompartmental models in the BA-CALC 2008 program ver. 1.0.0. RESULTS: There were no significant associations between blood pressure changes and pharmacokinetic parameters of valsartan. Blood pressure pattern change analysis showed significant results. For AUCt, total amount of absorbed valsartan was 25,808 +/- 6,863.0 ng.hr/mL, 20,683 +/- 8,782.7 ng.hr/mL, and 12,502 +/- 5,566.6 ng.hr/mL in responder, non-responder, and reverse responder, respectively (p = 0.041). In C max, maximum concentration of valsartan was 4,314 +/- 1,522.6 ng/mL, 2,588 +/- 1,273.9 ng/mL, and 2,056 +/- 1,075.5 ng/mL, respectively. CONCLUSIONS: These results showed that response to valsartan was not associated with blood concentration in healthy volunteers and changes in blood pressure patterns to valsartan might be associated with the amount of drugs which are absorbed to subjects.
Assuntos
Humanos , Masculino , Pressão Sanguínea , Monitorização Ambulatorial da Pressão Arterial , Hipertensão , Espectrometria de Massas , Plasma , Receptores de Angiotensina , Tetrazóis , Valina , ValsartanaRESUMO
BACKGROUND: This study was conducted to determine the early cardiac valvular changes in young male ankylosing spondylitis (AS) patients. METHODS: A total of 70 AS patients on treatment without clinical cardiac symptoms were divided into group I ( or = 10 years, n = 20) depending on their disease duration after first diagnosis. Twenty-five healthy volunteers were selected as control subjects. All the subjects underwent transthoracic and transesophageal echocardiography, electrocardiography, and rheumatologic evaluation for AS patients. RESULTS: The thickness of both the aortic and mitral valve was more increased in AS patients than in controls. Aortic valve thickness over 1.3 mm could predict AS with a sensitivity of 73% and specificity of 76%. The prevalence of aortic valve thickening was higher in the AS group compared to the controls. The prevalence of aortic and mitral regurgitation was very low and there was no difference between the controls and the patients. The aortic valve thickening was related to longer disease duration, high blood pressure, disease activity and inflammatory markers. CONCLUSION: Thickening of the aortic and mitral valve was observed without regurgitation in male AS patients early in the course of their disease without clinical cardiac manifestations. This subclinical change of aorto-mitral valve in early AS should be considered and followed up to determine its prognostic implication and evolution.
Assuntos
Humanos , Masculino , Valva Aórtica , Ecocardiografia , Ecocardiografia Transesofagiana , Eletrocardiografia , Valvas Cardíacas , Hipertensão , Valva Mitral , Insuficiência da Valva Mitral , Prevalência , Sensibilidade e Especificidade , Espondilite AnquilosanteRESUMO
BACKGROUND: This study was conducted to determine the early cardiac valvular changes in young male ankylosing spondylitis (AS) patients. METHODS: A total of 70 AS patients on treatment without clinical cardiac symptoms were divided into group I ( or = 10 years, n = 20) depending on their disease duration after first diagnosis. Twenty-five healthy volunteers were selected as control subjects. All the subjects underwent transthoracic and transesophageal echocardiography, electrocardiography, and rheumatologic evaluation for AS patients. RESULTS: The thickness of both the aortic and mitral valve was more increased in AS patients than in controls. Aortic valve thickness over 1.3 mm could predict AS with a sensitivity of 73% and specificity of 76%. The prevalence of aortic valve thickening was higher in the AS group compared to the controls. The prevalence of aortic and mitral regurgitation was very low and there was no difference between the controls and the patients. The aortic valve thickening was related to longer disease duration, high blood pressure, disease activity and inflammatory markers. CONCLUSION: Thickening of the aortic and mitral valve was observed without regurgitation in male AS patients early in the course of their disease without clinical cardiac manifestations. This subclinical change of aorto-mitral valve in early AS should be considered and followed up to determine its prognostic implication and evolution.
Assuntos
Humanos , Masculino , Valva Aórtica , Ecocardiografia , Ecocardiografia Transesofagiana , Eletrocardiografia , Valvas Cardíacas , Hipertensão , Valva Mitral , Insuficiência da Valva Mitral , Prevalência , Sensibilidade e Especificidade , Espondilite AnquilosanteRESUMO
While the disease course of stress-induced cardiomyopathy (SIC) is usually benign, it can be fatal. The prognostic factors to predict poorer outcome are not well established, however. We analyzed the Acute Physiology And Chronic Health Evaluation (APACHE) II score to assess its value for predicting poor prognosis in patients with SIC. Thirty-seven consecutive patients with SIC were followed prospectively during their hospitalization. Clinical factors, including APACHE II score, coronary angiogram, echocardiography and cardiac enzymes at presentation were analyzed. Of the 37 patients, 27 patients (73%) were women. The mean age was 66.1 +/- 15.6 yr, and the most common presentation was chest pain (38%). Initial echocardiographic left ventricular ejection fraction (EF) was 42.5% +/- 9.3%, and the wall motion score index (WMSI) was 1.9 +/- 0.3. Six patients (16%) expired during the follow-up period of hospitalization. Based on the analysis of characteristics and clinical factors, the only predictable variable in prognosis was APACHE II score. The patients with APACHE II score greater than 20 had tendency to expire than the others (P = 0.001). Based on present study, APACHE II score more than 20, rather than cardiac function, is associated with mortality in patients with SIC.
Assuntos
Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , APACHE , Dor no Peito/etiologia , Ecocardiografia , Estimativa de Kaplan-Meier , Valor Preditivo dos Testes , Prognóstico , Estudos Prospectivos , Curva ROC , Cardiomiopatia de Takotsubo/diagnóstico , Função Ventricular EsquerdaRESUMO
BACKGROUND AND OBJECTIVES: Treadmill exercise stress echocardiography (TSE) has superior diagnostic accuracy than exercise electrocardiography (ECG). The objectives of the study are 1) to define the diagnostic accuracy and safety of TSE in patients without a history of coronary artery disease (CAD), 2) to identify the clinical characteristics that predict positive TSE results and 3) to assess the differential predictive value between TSE and concomitant exercise ECG in a Korean population. SUBJECTS AND METHODS: A total of 1,287 patients among 1,500 consecutive patients with no prior history of CAD and who were referred for TSE during a 4-year 3-month period were enrolled. RESULTS: Of the 1,287 patients, 95 (7.4%) showed positive TSE results (newly developed regional wall motion abnormality). Among the 154 patients with coronary angiography, 94 patients (61%) showed significant CAD (30 of 77 patients with negative TSE results and 64 of 77 patients with positive TSE results). The TSE positive population had more cardiovascular risk factors and showed a higher Duke treadmill score and wall motion score index than the TSE negative group. TSE showed relatively good sensitivity (68%), specificity (78%) and positive and negative predictive values (83% and 61%, respectively), and TSE also had higher diagnostic accuracy than concomitant exercise ECG (72% vs. 64%, respectively). CONCLUSION: TSE is safe and offers greater diagnostic power for CAD than exercise ECG in Korean population without a history of CAD. Its prognostic value in this population needs to be confirmed in a larger prospective study.
Assuntos
Humanos , Angiografia Coronária , Doença da Artéria Coronariana , Vasos Coronários , Ecocardiografia sob Estresse , Eletrocardiografia , Teste de Esforço , Fatores de Risco , Sensibilidade e EspecificidadeRESUMO
BACKGROUND AND OBJECTIVES: The prognostic value of biochemical markers and the resolution of ST-segment elevation on electrocardiogram are well established. However, how a combination of these two tools affects the evaluation of risk stratification has not yet been evaluated. SUBJECTS AND METHODS: Between January 2006 and June 2008, 178 consecutive patients treated with primary percutaneous coronary interventions after ST-segment elevation myocardial infarctions (STEMI) were analyzed at two coronary care units. Patients were divided into the following three groups according to ST-segment resolution: complete (> or =70% depression of the elevated ST-segment, n=63), partial (30% to 70%, n=90), and incomplete (<30%, n=25). Demographic data, including history, electrocardiography, biochemical markers, initial ejection fraction, and angiographic findings were also evaluated. RESULTS: There were 7 deaths, 3 repeated myocardial infarctions, and 17 readmissions for worsening heart failure during six months of follow-up. In a multivariate analysis to predict clinical outcomes, ejection fraction {hazard ratio (HR): 0.83 (0.76-0.91), p<0.01}, high-sensitivity C-reactive protein {HR: 1.15 (1.05-1.26), p<0.05}, and the degree of ST-segment resolution {HR: 0.96 (0.93-0.09), p<0.05} were independently associated with clinical outcomes. According to the Cox-proportional hazards model, the addition of ST-segment resolution markedly improved the prognostic utility of the model containing biochemical markers and ejection fraction. CONCLUSION: Assessment of biomarkers upon admission and ST-segment resolution are strong predictors of clinical outcomes. The combination of these data provides additive information about prognosis at an early point in the disease progression and further improves risk stratification for STEMI.
Assuntos
Humanos , Biomarcadores , Proteína C-Reativa , Unidades de Cuidados Coronarianos , Depressão , Progressão da Doença , Eletrocardiografia , Seguimentos , Insuficiência Cardíaca , Análise Multivariada , Infarto do Miocárdio , Intervenção Coronária Percutânea , Prognóstico , Modelos de Riscos ProporcionaisRESUMO
BACKGROUND: Waon therapy has beneficial effects on chronic heart failure (CHF), peripheral arterial disease, and other various diseases. This was to assess the safety and effect of Waon therapy by echocardiography for the first time in Korea. METHODS: Ten patients with CHF were enrolled. The patients with a light gown were placed in a sitting-position in an evenly maintained 60degrees C dry sauna system for 15 minutes, and then after leaving the sauna, they underwent bed rest with a blanket to keep them warm for an additional 30 minutes. Waon therapy was performed once a day, 5 days a week. RESULTS: Four of the 5 patients who had been treated for more than 2 weeks as protocol noted improvement of heart failure (HF) symptoms and decrease in left ventricular (LV) volume. There were trends in improvement of LV ejection fraction and parameters of diastolic function after the therapy although statistical significance was lack. No one complained of worsening of HF symptoms. In each session, body weight (61.8+/-10.2 kg vs. 61.6+/-10.3 kg, p=0.008) and blood pressure (systolic, 119+/-28 vs. 111+/-27 mmHg, p=0.005; diastolic, 69+/-12 mmHg vs. 63+/-10 mmHg, p=0.005) were significantly decreased, oral temperature (35.9+/-0.4degrees C vs. 37.0+/-0.9degrees C, p=0.017) was increased by 1.0degrees C at the end of sauna bathing, but the heart rate (71+/-10/min vs. 72+/-8/min, p=0.8) was not changed. CONCLUSION: We have experienced Waon therapy which was safe and well tolerated and some beneficial effects for patients with CHF. Large scale randomized study is needed to apply Waon therapy as a promising therapy in Korean HF patients.
Assuntos
Humanos , Banhos , Repouso em Cama , Pressão Sanguínea , Peso Corporal , Ecocardiografia , Insuficiência Cardíaca , Frequência Cardíaca , Coreia (Geográfico) , Luz , Doença Arterial Periférica , Banho a VaporRESUMO
The monoclonal gammopathies (MG) are monoclonal neoplasms related to each other by virtue of their development from common progenitors in the B lymphocyte lineage. Cardiac dysfunction in patients with MG is not well established. We experienced a case of cardiac dysfunction associated with MG identified by echocardiography and biopsy. Fifty nine year-old man was admitted because of dyspnea for several months. Echocardiography revealed diastolic dysfunction showing restrictive physiology with elevated left ventricular filling pressure. Bone marrow (BM) studies and immunoelectrophoresis were compatible with monoclonal gammopathy of undetermined significance. Endomyocardial, BM, and enteral biopsies for ruling out for amyloidosis (Congo-red stain) were negative. This is the case of non-amyloidotic light chain deposition cardiomyopathy.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Medula Óssea/patologia , Cardiomiopatias/diagnóstico , Cadeias kappa de Imunoglobulina/análise , Paraproteinemias/complicaçõesRESUMO
BACKGROUND: Coronary artery disease (CAD) has recently become one of the major causes of mortality and morbidity in Korea. However, not much epidemiologic and demographic data has yet been reported. The purpose of this study was to investigate the clinical features as well as the prognostic factors of patients with CAD. METHODS: We prospectively enrolled 1,665 consecutive patients with CAD who had been admitted to the Catholic University Hospitals from December 1999 to April 2003. RESULTS: Acute myocardial infarction (AMI) was the most common cause of admission (n=715, 42.9%). Dyslipidemia, hypertension and smoking were the most common risk factors. More than 70% of the patients who underwent percutaneous coronary intervention (PCI) received stent implantation. A total of 965 (612 males) patients were followed at least for 6 months (the mean follow-up duration was 23.8+/-12.2 months). The incidence rates of major adverse cardiac events (MACE: cardiac death, acute myocardial infarction, target vessel revascularization) and cardiac death were 15.1% (n=146) and 2.2% (n=21), respectively. There was no difference in overall survival between the patients treated with medical therapy and those treated with PCI. By Cox regression analysis, the independent prognostic factors for MACE were PCI (95% CI: 1.75-4.85; p<0.01) and multivessel disease (95% CI: 1.03-2.04; p<0.05), and the independent prognostic factors for cardiac death were medical therapy (95% CI: 1.08-14.41; p<0.05) and old age (95% CI: 1.13-16.13; p<0.05). CONCLUSIONS: There was no difference in overall survival between the patients treated with medical therapy and those treated with PCI. However, PCI was superior to medical therapy for preventing death of the patients with acute coronary syndrome.
Assuntos
Humanos , Síndrome Coronariana Aguda , Doença da Artéria Coronariana , Doença das Coronárias , Vasos Coronários , Morte , Dislipidemias , Seguimentos , Coração , Hospitais Universitários , Hipertensão , Incidência , Coreia (Geográfico) , Mortalidade , Infarto do Miocárdio , Intervenção Coronária Percutânea , Prognóstico , Estudos Prospectivos , Fatores de Risco , Fumaça , Fumar , StentsRESUMO
BACKGROUND: Most of the known risk factors associated with ischemic heart disease are based on studies from Western countries; there is only limited information on Korean populations. This study was designed to analyze age related differences in epidemiologic and clinical characteristics in patients who were admitted for coronary angiography for the evaluation of ischemic heart disease. METHODS: As part of the multicenter KCAR (Korean Coronary Artery disease Registry) Study, the clinical data of 6,549 patients, who were evaluated at the cardiac catheterization laboratory by coronary angiography, at seven university hospitals in Korea from March 1999 to December 2005, were registered into the KCAR database and analyzed. All patients were divided into three groups according to age: age or =71. All demographic and coronary angiographic features were analyzed for the different groups. RESULTS: The demographic data showed that compared to the older patients young patients < or =40 had a higher prevalence of males and smokers, but a lower prevalence of hypertension, diabetes and prior history of stroke and myocardial infarction. For the lipid profiles, the younger patients had much higher levels of total cholesterol, triglycerides and LDL-cholesterol than the older groups; however, there was no difference in the HDL-cholesterol levels among the three age groups. The most common component of the metabolic syndrome was obesity (79%) in the younger patients and hypertension (92%) in the older patients. The most common reason for presentation was ST-segment elevated myocardial infarction in the younger patients and unstable angina in the older patients. CONCLUSIONS: Ischemic heart disease in younger adults < or =40 had different demographic characteristics and clinical presentation than older patients.
Assuntos
Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Etários , Angiografia Coronária , Complicações do Diabetes/epidemiologia , Hospitais Universitários , Hipertensão/epidemiologia , Coreia (Geográfico)/epidemiologia , Síndrome Metabólica/epidemiologia , Isquemia Miocárdica/diagnóstico , Prevalência , Estudos Prospectivos , Sistema de Registros , Fatores de Risco , FumarRESUMO
Subaortic left brachiocephalic vein is a rare congenital anomaly that is sometimes found in the normal population. We report here on a case of subaortic left brachiocephalic vein that was detected incidentally by performing contrast transesophageal echocardiography (TEE) with using agitated saline and computed tomography (CT).
Assuntos
Veias Braquiocefálicas , Doenças e Anormalidades Congênitas, Hereditárias e Neonatais , Di-Hidroergotamina , Ecocardiografia TransesofagianaRESUMO
BACKGROUND AND OBJECTIVES: Currently, the drug-eluting stent (DES) has been widely used because of its excellent clinical outcome. We compared the utilization patterns and clinical outcomes between the DES and the bare metal stent (BMS) in the real world. SUBJECTS AND METHODS: We retrospectively reviewed the stent registry at the Catholic Medical Center between January 2002 and October 2004. There were 1120 patients treated with DES (n=1837) who were compared to 910 patients who received BMS implantation (n=1238). RESULTS: Patients with de novo lesions in the DES group more frequently had multivessel disease and received a greater number of stents than those in BMS group (p<0.001). The mean diameter of inserted stents was smaller in the DES group (p<0.001). The follow-up rate for clinical and angiographic evaluations at 6 months after stenting was 91% and 65% (n=592) in the BMS group and 90% and 74% (n=829) in the DES group, respectively. The rate of major adverse cardiac events (death, nonfatal myocardial infarction, or target vessel revascularization) at 6 months was 7.3% in the DES group and 17.5% in the BMS group (p<0.001). The rates of target vessel revascularization in the DES group and in the BMS group were 4.2% and 12.9%, respectively (p<0.001). CONCLUSION: The patients in the DES group had longer length, smaller diameter and higher number of placed stents, compared to the BMS group. The rates of revascularization and major adverse cardiac events in the DES group were lower than those in the BMS group.
Assuntos
Humanos , Angioplastia , Stents Farmacológicos , Seguimentos , Infarto do Miocárdio , Prognóstico , Estudos Retrospectivos , StentsRESUMO
There has been a number of reports recently describing the pathogen potential of irregular asporogenous gram positive rods (IGPR), also referred as coryneforms or diphtheroids. This may be due to a greater number of opportunistic infections occurring in patients who are immunosuppressed or implanted with prostheses. The documentation of endocarditis caused by IGPR is difficult. Because all the result of culture is not always positive and these cultures need long-period incubation, and there are sometimes pseudo-positive cases due to the contamination in blood sampling. An early diagnosis and adequate treatment are important for the better result. We describe the case of bio prosthetic valve endocarditis in a 61-year-old woman who enduring chronic hemodialysis. This is the first case reported of bioprosthetic valve endocarditis by Corynebacterium in Korea.
Assuntos
Feminino , Humanos , Pessoa de Meia-Idade , Corynebacterium , Diagnóstico Precoce , Endocardite , Bacilos Gram-Positivos , Coreia (Geográfico) , Infecções Oportunistas , Próteses e Implantes , Diálise RenalRESUMO
BACKGROUND AND OBJECTIVES: This study was designed to formulate a method for the qualitative and quantitative measurements of aortic valve sclerosis (AVS) and to assess the relationship between this method and the degree of the carotid intima-media thickness (IMT) in neurologically asymptomatic patients. SUBJECTS AND METHODS: One hundred and seventeen patients (Male 43%, 57.9+/-13.1 years of age) were retrospectively studied. Only the right- and non-coronary cusps were analyzed. AVS (cusp thickness of > or =2.0 mm) severities were classified into two groups according to the thickness and presence of the restricted motion of the cusp : mild AVS : AVS of or =3.0 mm. The far wall IMT was measured at its thickest part in the distal 10.0 mm section of the common carotid artery. A protruding lesion with a far wall IMT > or =1.2 mm in the carotid bulb was defined as a plaque. RESULTS: According to the severity of AVS, there was a significant difference in the prevalence of an IMT > or =0.8 mm (38.7 vs. 50.0 vs. 75.8%, p0.005 for trend) and > or =1.0 mm (14.5 vs. 13.6 vs. 42.4%, p0.005 for trend), and a plaque (19.4 vs. 36.4 vs. 54.5%, p0.0005 for trend). The severity of AVS was independently correlated with an IMT > or =0.8 mm and IMT > or =1.0 mm, and with the presence of a plaque from a multiple logistic regression model. CONCLUSION: There was a significant association between AVS and the carotid IMT/plaque in relation to both in the presence and severity.