Article Text

Download PDFPDF
Carotid Intima-Media Thickness and Stiffness Are Independent Risk Factors for Atherosclerotic Diseases
  1. Shih-Te Tu, MD*,
  2. I-Wen Wang, MS,
  3. Hsiu-Fen Lin, MD,
  4. Yi-Chu Liao, MD, MS§∥,
  5. Ruey-Tay Lin, MD,
  6. Chin-San Liu, MD, PhD,
  7. Juo SHH, MD, PhD†#
  1. From the *Department of Internal Medicine, Lukang Christian Hospital and Changhua Christian Hospital, Changhua; and Departments of †Medical Genetics, ‡Neurology, and §Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung; ∥Department of Neurology, Taichung Veterans General Hospital, Taichung; ¶Vascular & Genomic Center and Department of Neurology, Changhua Christian Hospital; Changhua; and #Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
  1. Received February 24, 2010, and in revised form May 3, 2010.
  2. Accepted for publication May 12, 2010.
  3. Reprints: Suh-Hang Hank Juo, MD, PhD, Kaohsiung Medical University, 100 TzYou First Rd, Kaohsiung 807, Taiwan. E-mail: hjuo{at}
  4. Part of the information was presented as a poster in a domestic meeting.
  5. None of the authors have potential conflicts of interest.
  6. This study was funded by the National Health Research Institutes, Taiwan (NHRI-Ex96-9607PI for H.-F.L., Y.-C.L., and S.-H.H.J.) and the CCH-KMU Research Funding (97-CCH-KMU-032 for S.-T.T., C.-S.L., and S.-H.H.J.
  7. Supplemental digital content is available for this article. Direct URL citation appears in the printed text and is provided in the HTML and PDF versions of this article on the journal's Web site (


Objective We assessed the correlation between intima-media thickness (IMT) and stiffness and test whether they are independent risk factors for atherosclerotic diseases.

Methods We enrolled 2333 participants from the general population. Among the study subjects, 197 subjects had a history of stroke or myocardial infarction (MI) and were treated as patients, and the rest were the control subjects. Intima-media thickness was measured at the common carotid artery (CCA), bifurcation, and internal carotid artery. Three parameters (arterial stiffness [β], elastic modulus, and pulse wave velocity) were measured for carotid stiffness. Correlation between IMT and stiffness was first calculated. Multivariate regression model was used to evaluate whether inclusion of both IMT and stiffness can increase the prediction of cardiovascular events.

Results Only CCA and bifurcation IMTs were significantly and positively correlated with stiffness. After adjusting for age and sex, the correlations were substantially attenuated. Common carotid artery IMT was most significantly associated with stroke and MI (P = 2.6 × 10−8) followed by bifurcation IMT (P = 5.5 × 10−6), and internal carotid artery IMT was least significant (P = 0.02). For stiffness, β was most significant (P = 3.6 × 10−8) for stroke and MI, followed by elastic modulus (P = 1.1 × 10−6) and pulse wave velocity (P = 6.8 × 10−6). The best model for the combined effect was from β (P < 0.03) and CCA (P = 0.056) or bifurcation IMT (P = 0.057).

Conclusions Carotid IMT and stiffness represent different properties of atherosclerotic vessel wall. Measuring both traits provides a better characterization of atherosclerosis.

Key Words
  • intima-media thickness
  • stiffness
  • carotid artery

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.