O espessamento médio-intimal como preditor de doença arterial coronariana: implicações da aterosclerose subclínica

Abstract

OBJECTIVE: To understand the correlation between carotid intima-media thickness (cIMT) and the presence of coronary artery disease (CAD). METHODS: This is a narrative literature review. Observational studies, meta-analyses, systematic reviews, and randomized clinical trials from 2016 to 2024 were considered. RESULTS: cIMT is recognized as a subclinical indicator of atherosclerosis and a predictor of CAD, serving as a cardiovascular risk marker. It is associated with risk factors such as systemic arterial hypertension (SAH), type 2 diabetes mellitus (T2DM), dyslipidemia, and smoking. SAH and T2DM promote oxidative stress and inflammation, contributing to increased cIMT. Evidence indicates that antihypertensive and lipid-lowering therapies may reduce cIMT. Smoking also worsens this condition, favoring the deposition of atherosclerotic plaques. The global prevalence of elevated cIMT is 27.6% among people aged 30 to 79, reflecting the universality of atherosclerosis. cIMT progression shows sex-related differences, generally being higher in men due to variations in atherosclerosis composition and morphology between sexes. Studies suggest that reducing risk factors, such as controlling SAH and T2DM, may slow cIMT progression and decrease coronary events. CONCLUSION: cIMT assessment via carotid ultrasonography is recommended to identify at-risk individuals and implement preventive interventions, making it a valuable tool in cardiovascular risk assessment.

Keywords: Atherosclerosis; Carotid intima-media thickness; Coronary artery disease