Objective     To identify the relationship of carotid intima-media thickness (CIMT)

microalbuminuria (MA) level

and atherosclerosis extent with the rate of cardiovascular events in patients with polyvascular atherosclerosis.     Metho

ds      A total of 149 patients with polyvascular atherosclerosis with angiographic arterial stenosis ≥50% in 1

2

3 or 4 territories (coronary

supraaortic

renal and/or lower limb arteries) who admitted in our hospital from June 2007 to June 2009 and underwent revascularization procedure in ≥1 arterial territory were enrolled in this study. These patients were divided into 4 groups according to their atherosclerosis extent

group 1 with stenosis in 1 territory (n=40)

group 2 in 2 territories (n=40)

group 3 in 3 territories (n=37)

and group 4 in 4 territories (n=32). Baseline mean-CIMT and MA was assessed in the 149 patients and 40 control subjects who were suspected with arterial stenosis but diagnosed without after angiography at the time of hospitalization.  Incidence of cardiovascular events were observed during the follow-up of 14.6±4.9 months.     Results     For CIMT ≥1.38 mm (≥3rd quartile)

the sensitivity and specificity of ≥3-territory involvement were 90.0% and 82.6%. For MA≥6.85 mg/dl (≥3rd quartile)

the sensitivity and specificity of ≥2-territory involvement were 54.9% and 83.3%. Cardiovascular events occurred in 104 subjects of 149 patients. The Kaplan Meier 2-year cardiovascular event-free survival was 93.9% and 95.7%

95.7% and 89.6%

73.9% and 72.3%; and 59.6% and 66.0% respectively in patients with mean-CIMT and MA values in the 1st

2nd

3rd and 4th quartile. The multivariable Cox proportional hazard model identified that mean-CIMT ≥1.38 mm (RR=1.83

95% CI=1.049 to 3.196; P0.001) and MA ≥6.84 mg/dl (RR=0.99

95% CI=0.576 to 1.703; P0.001) were independant adverse event predictors. Inclusion of CIMT into the stratification model significantly improved the prediction of cardiovascular event risk (_chi

2

=7.098

P0.01) whereas the impact of MA was not significant (_chi

2

=0.002

P0.01).     Conclusion      In patients undergoing revascularization procedure(s)

CIMT exerts an important and independent contribution to further cardiovascular risk stratification. The mean-CI

MT value ≥1.38 mm is associated with 1.8-fold increased risk of adverse cardiovascular events

and the MA value ≥6.85 mg/dl is associated with nearly 1-fold increased risk of adverse  cardiovascular events.