The triple line pattern on carotid intima media thickness imaging and its relationship to cardiovascular risk factors in patients on lipid lowering therapy

Figures & data

Figure 1 CIMT images showing sample patients in whom TLP (arrow) is absent (left) and present (right).

Note: There is a visible horizontal interface between the upper and lower CIMT border.
Abbreviations: CIMT, carotid intima media thickness; TLP, triple line pattern.

Table 1 Baseline demographics (N=120)

Age (years)	66.7±10.9
Male sex	100 (83.3%)
Female sex	20 (33.6%)
Statin used
Simvastatin	71 (59.2%)
Atorvastatin	45 (37.5%)
Pravastatin	4 (3.3%)
Initial statin dose (mg)	44±23
Duration of prior statin therapy (years)	6.3±5.2
Hypertension	112 (93.3%)
Diabetes	50 (41.7%)
Family history of heart disease	51 (42.5%)
Angina with positive stress test	43 (35.8%)
Angiographic CAD	73 (60.8%)
Prior myocardial infarction	39 (32.5%)
Prior percutaneous revascularization	36 (30%)
Prior coronary artery bypass graft surgery	37 (30.8%)
Prior stroke	1 (0.8%)
Heart failure	4 (3.3%)
Atherosclerotic peripheral vascular disease	7 (5.8%)
Tobacco use
Non-smoker	100 (83.3%)
Ex-smoker ≥3 years	14 (11.7%)
Active smoker	6 (5%)
Weight (pounds)	204.1±39.1
Height (inches)	68.1±4.0
Systolic blood pressure (mmHg)	134.9±18.1
Diastolic blood pressure (mmHg)	74.1±9.7
Pulse pressure (mmHg)	61±17
Total cholesterol (mg/dL)	146.1±27.7
Triglycerides (mg/dL)	141.9±77.0
High density lipoprotein (mg/dL)	42.5±8.4
Low density lipoprotein (mg/dL)	81.9±20.7
Very low density lipoprotein (mg/dL)	21.8±13.2
Median high sensitivity CRP (g/L)	1.9 (0.9–4.5)
Glucose (mg/dL)	104.0±29.1
Lipoprotein (a) (mg/dL)	78.4±16.5

Note: Totals presented as either mean ± SD or percentages.

Abbreviations: CAD, coronary artery disease; CRP, C-reactive protein; SD, standard deviation.

Table 2 Baseline characteristics of patients with, and without, presence of the TLP

Characteristic (mean ± SD)	TLP not present (N=93)	TLP present (N=27)	P-value
Age (years)	67.3±10.9	64.52±10.8	0.24
Initial statin dose (mg)	43±21	47±27	0.41
Duration of prior statin therapy (years)	6.6±5.6	5.3±3.3	0.27
Weight (pounds)	206.7±40.5	195.1±32.7	0.18
Systolic blood pressure (mmHg)	133.1±18.4	141.3±15.6	0.04
Diastolic blood pressure (mmHg)	73.3±9.6	77.0±9.5	0.08
Pulse pressure (mmHg)	60±17	64±14	0.22
Abdominal girth (inches)	40.9±5.1	39.7±4.8	0.24
Total cholesterol (mg/dL)	146.2±28.2	145.9±26.5	0.96
Triglycerides (mg/dL)	145.1±83.4	130.8±47.0	0.41
High density lipoprotein (mg/dL)	42.3±8.8	43.4±6.7	0.57
Low density lipoprotein (mg/dL)	81.6±20.9	83.1±20.0	0.74
Median high sensitivity CRP (g/L)	2.0 (1.0–4.7)	1.5 (0.7–4.1)	0.30
Glucose (mg/dL)	103.4±29.9	103.4±24.3	0.90
Mean CIMT	0.911±0.162	0.921±0.153	0.79

Abbreviations: TLP, triple line pattern; CRP, C-reactive protein; CIMT, carotid intima media thickness; SD, standard deviation.

Table 3 Change in prevalence of the TLP at baseline and at 14 months

Baseline	14 months	N (% of 120)
Absent	Absent	48 (40)
Present	Present	20 (16.7)
Absent	Present	45 (37.5)
Present	Absent	7 (5.8)
Total prevalence at 14 months		65 (54.2)

Abbreviation: TLP, triple line pattern.