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• W2930816533 abstract "The identification of arterial wall changes in asymptomatic subjects indicates theneed for more strict control of macrovascular risk factors, seeking to prevent futuremacrovascular events.Population and hospital based studies using non-invasive techniques to evaluateearly changes in the structure and function of the arterial wall, such as the measurementof intima media wall thickness, investigation of endothelial dysfunction andmacrovascular calcification (63, 64, and 65) have been employed for the purpose.Studies determined 0.8 mm as the reference values for early thickening of theintima media complex associated with an increase in macrovascular risk (54, 66-69).Grook et al conducted a study with 315 patients with familial hypercholesterolemiacompared 118 controls and showed that an intima media thickening of up to 0.8 mmwould be considered normal.The present study shows that even asymptomatic patients with T2DM hasincreased carotid IMT value and the risk of acquiring macro vascular combinationincrease as IMT value increases.This study shows that increasing CIMT is strongly associated with macrovasculardisease. In the present study we used mean aggregate IMT of the extra cranial arteries(altogether 6 sites at each common carotid artery, the bifurcation and the internal carotidartery) including thickness of plaque lesion, with a view to evaluate the associationbetween macrovascular status and grade of carotid atherosclerosis. Mean IMT aggregatehas been accessed in many previous studies, although in same of them it proved difficultto evaluate internal carotid intima media thickness precisely (50, 59). However,technological advancement in ultrasound equipment and the availability of highresolution transducer has allowed more accurate evaluation of arterial wall structure inpast decade.The present study showed carotid artery IMT was higher in patients withmacrovascular complication in T2DM than in patients without macrovascularcomplications in T2DM. Thickening of the mean aggregate intima media complex justover 1 mm may prove to the predictive of significant macrovascular disease in nearly95% of the patients.The study observations are consistent with several previous studies Crouse et al(58) found a strong correlation between macrovascular disease and increased IMT incarotid artery diseases. Likewise, in my study mean aggregate IMT increases withadvancing macrovascular disease.Other investigators carried out population based studies in which IMT wasevaluated with regard to the number and incidence of stroke or acute coronarysyndromes (60). A strong association between IMT and risk of stroke and myocardialinfection was established in Rotterdam study (60). Bots et al (53) used B modeultrasonography to study the carotid arteries of 7983 patients aged over 55 years.Throughout 4.6 years of observation they registered 194 new myocardial infections inthe study going patients who has myocardial infarction had significantly higher IMTthan others.Furthermore, O’ leary et al (55) having examined over 5800 patients (>65 years)with high resolution ultrasonography found increased IMT of carotid arteries directlyassociated with increased risk of myocardial infarction and stroke.Since, both the sensitivity and specificity of Treadmill testing andEchocardiography are limited; the introduction of IMT measurements of the carotidarteries may contribute significantly to diagnose the status of patients. In these patientshigh aggregated IMT in carotid arteries may be adhesive factor in introduction ofeffective medical treatment such as statins and antihypertensive drugs along witheffective blood sugar control.IMT may be considered as another risk factor for CAD, in the same way ofDiabetes, hypertension according to recommendations of European society of cardiologypublications 2000.The non-invasive assessment of common carotid intima media thickness appearsto provide a promising method of study of atherosclerosis directly at the level of vesselin population at large. The use of carotid intima media thickness measurements as anindicator of generalized atherosclerosis is conditioned on the view that its measurementreflects on macrovascular disease risk.CONCLUSION :In conclusion, the present studies based on short follow up periods:1. Even in asymptomatic type 2 diabetic patients have increased carotid intimamedia thickness.2. An increase in carotid intima media thickness strongly goes in hand withmacrovascular complications.3. Intima media thickness measurement has an intermediate or proxy end point inobservational and interventional study." @default.
• W2930816533 created "2019-04-11" @default.
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• W2930816533 date "2009-03-01" @default.
• W2930816533 modified "2023-09-26" @default.
• W2930816533 title "Evaluation of Carotid Intima Media thickness as a predictor of Macrovascular complications in Type 2 Diabetes Mellitus" @default.
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