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Carotid intima-media thickness is increased in patients with spinal cord injury independent of traditional cardiovascular risk factors

2008; Elsevier BV; Volume: 202; Issue: 1 Linguagem: Inglês

10.1016/j.atherosclerosis.2008.04.013

1879-1484

José R. Matos‐Souza, Karla Rocha Pithon, Tatiana Mirabetti Ozahata, Tiago Gemignani, Alberto Cliquet, Wilson Nadruz,

Aortic Disease and Treatment Approaches

Cardiovascular disease is the leading cause of mortality in persons with spinal cord injury (SCI) and coronary heart disease is more prevalent in SCI individuals than in the able-bodied population [ 1 Hartkoop A. Bronnum-Hansen H. Seidenschnur A.M. Biering-Sorensen F. Survival and cause of death after traumatic spinal cord injury. A long-term epidemiological survey from Denmark. Spinal Cord. 1997; 35: 76-85 Crossref PubMed Scopus (157) Google Scholar , 2 Yekutiel M. Brooks M.E. Ohry A. Yarom J. Carel R. The prevalence of hypertension, ischaemic heart disease and diabetes in traumatic spinal cord injured patients and amputees. Paraplegia. 1989; 27: 58-62 Crossref PubMed Scopus (227) Google Scholar ]. Possible explanations to these findings have been related to an increased prevalence of atherosclerotic risk factors such as low HDL and impaired glucose tolerance secondary to physical inactivity and changes in body composition [ 2 Yekutiel M. Brooks M.E. Ohry A. Yarom J. Carel R. The prevalence of hypertension, ischaemic heart disease and diabetes in traumatic spinal cord injured patients and amputees. Paraplegia. 1989; 27: 58-62 Crossref PubMed Scopus (227) Google Scholar , 3 Demirel S. Demirel G. Tukek T. Erk O. Yilmaz H. Risk factors for coronary heart disease in patients with spinal cord injury in Turkey. Spinal Cord. 2001; 39: 134-138 Crossref PubMed Scopus (74) Google Scholar , 4 Carvalho D.C. de Cássia Zanchetta M. Sereni J.M. Cliquet A. Metabolic and cardiorespiratory responses of tetraplegic subjects during treadmill walking using neuromuscular electrical stimulation and partial body weight support. Spinal Cord. 2005; 43: 400-405 Crossref PubMed Scopus (38) Google Scholar ]. Carotid intima-media thickness (IMT) is a surrogate marker for early atherosclerosis. Noticeably, this procedure shares a good correlation with histology [ [5] Pignoli P. Tremoli E. Poli A. Oreste P. Paoletti R. Intimal plus medial thickness of the arterial wall: a direct measurement with ultrasound imaging. Circulation. 1986; 74: 1399-1406 Crossref PubMed Scopus (2149) Google Scholar ] and is a strong predictor of future vascular events [ [6] Lorenz M.W. Markus H.S. Bots M.L. Rosvall M. Sitzer M. Prediction of clinical cardiovascular events with carotid intima-media thickness: a systematic review and meta-analysis. Circulation. 2007; 115: 459-467 Crossref PubMed Scopus (2366) Google Scholar ]. The present report aimed to evaluate whether there are differences on carotid IMT between SCI and matched able-bodied subjects and the impact of traditional cardiovascular risk factors in this regard.