Relação entre a ocorrência de infarto agudo do miocárdio com o espessamento do complexo médio-intimal das artérias carótidas: uma revisão integrativa

Abstract

Carotid artery intima-media thickness (IMT) is a measurement obtained by ultrasound that assesses the thickening of the inner layers of the arterial wall. Increased IMT is an early and noninvasive marker of atherosclerosis and is strongly associated with the risk of future cardiovascular events. This work is an integrative literature review that aims to answer the guiding question originated from the PICo strategy "What are the relationships between carotid artery intima-media complex thickening in patients who have suffered acute myocardial infarction" based on articles selected from the PubMed, LILACS, SciELO and Scopus platforms. Among the articles identified by the database search, 56 were found in PubMed, none in LILACS, 13 in SciELO and 28 in Scopus, thus 10 articles were included in the discussion of this review. Thus, studies demonstrate that carotid intima-media thickness (cIMT) is a consistent predictor of cardiovascular events. While some studies found no association between cIMT progression and cardiovascular risk, others showed that high values or sustained regression of cIMT are associated with higher or lower risk, respectively. The combination of cIMT with the presence of plaques and its application in specific subgroups, such as intermediate-risk patients or patients with AMI, can improve prognostic stratification. Therefore, cIMT has value in cardiovascular risk stratification. Furthermore, mean cIMT, especially in the common carotid and associated with plaques, is useful in cases of intermediate risk. The combination of these measurements with clinical scores can improve prognostic assessment, although further studies and standardization are still needed.