Usefulness of carotid intima-media thickness measurement as an indicator of generalized atherosclerosis: Findings from autopsy analysis

Background: Ultrasound-determined carotid intima-media thickness (IMT) is widely used as an indicator of generalized atherosclerotic burden, but there are limited autopsy findings in support of the association, directly. Methods: We performed an autopsy analysis (n = 111, mean 68.8 years; 65.0% men; 86% non-cardiovascular disease death) to examine the associations of microscopy-determined carotid IMT including plaque thickness with the severity of atherosclerosis in the generalized arteries. Results: Microscopy-determined carotid IMT was associated with the extent of intima/media layer ratio of the vasculature, a marker of atherosclerosis, in each structure examined, i.e., coronary artery, cerebrovasculature, thoracic aorta, abdominal aorta, and iliac artery (R = 0.31-0.42; all P < 0.01). The prevalence of a necrotic core in the coronary artery, cerebrovasculature, thoracic aorta, abdominal aorta, and iliac artery increased in accordance with increasing microscopy-determined carotid IMT (all P < 0.05). Conclusion: Our autopsy analysis confirms the validity of carotid IMT including plaque thickness as an indicator of generalized atherosclerosis.