Document Detail

Carotid plaque burden as a measure of subclinical atherosclerosis: comparison with other tests for subclinical arterial disease in the High Risk Plaque BioImage study.
MedLine Citation:
PMID:  22789936     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: The purpose of this study was to compare carotid plaque burden, carotid intima-media thickness (cIMT), ankle-brachial index (ABI), and abdominal aortic diameter (AAD) to coronary artery calcium score (CACS) in people without known cardiovascular disease.
BACKGROUND: The clinical utility of risk factors to predict cardiovascular events is limited. Detection of subclinical atherosclerosis by noninvasive tests such as CACS, cIMT, carotid plaque burden, AAD, and ABI may improve risk prediction above that of established risk scoring models, namely, Framingham Risk Score.
METHODS: The High Risk Plaque BioImage study investigated 6.101 asymptomatic persons and reports baseline CACS, cIMT, ABI, and AAD. In addition, we present findings from a new 3-dimensional-based ultrasound approach, where the carotid artery was investigated in cross section from proximal in the neck to as distal as possible. From the resulting 10-s video, plaque was outlined on cross-sectional images and all plaque areas were summarized into "plaque burden."
RESULTS: The mean age was 68.8 years, and 65.3% of subjects had intermediate Framingham Risk Score (6% to 20% 10-year risk). Carotid plaques were identified in 78% of cases, abnormal ABI in 10%, AAD >20 mm in 28%, and coronary calcium in 68% of participants. Carotid plaque burden was found to correlate stronger with CACS (chi-square 450, p < 0.0001) than did cIMT (chi-square 24, p < 0.0001), AAD (chi-square 2.9, p = 0.091), and ABI (chi-square 35.2, p < 0.0001).
CONCLUSIONS: In the BioImage study, a new 3-dimensional-based ultrasound method identified more carotid plaques than in previous studies. Compared to other methods, carotid plaque burden was the strongest cross-sectional predictor of CACS, and its clinical utility as predictor of future cardiovascular events is being evaluated in the BioImage study. (BioImage Study: A Clinical Study of Burden of Atherosclerotic Disease in an At-Risk Population; NCT00738725).
Henrik Sillesen; Pieter Muntendam; Aram Adourian; Robert Entrekin; Mario Garcia; Erling Falk; Valentin Fuster
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study    
Journal Detail:
Title:  JACC. Cardiovascular imaging     Volume:  5     ISSN:  1876-7591     ISO Abbreviation:  JACC Cardiovasc Imaging     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-07-13     Completed Date:  2012-12-03     Revised Date:  2013-02-27    
Medline Journal Info:
Nlm Unique ID:  101467978     Medline TA:  JACC Cardiovasc Imaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  681-9     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
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MeSH Terms
Aged, 80 and over
Ankle Brachial Index
Aorta, Abdominal / ultrasonography
Asymptomatic Diseases
Carotid Arteries / pathology,  ultrasonography*
Carotid Artery Diseases / diagnosis*,  pathology,  ultrasonography
Carotid Intima-Media Thickness
Chi-Square Distribution
Coronary Angiography / methods
Coronary Artery Disease / diagnosis*,  pathology,  radiography,  ultrasonography
Coronary Vessels / pathology,  ultrasonography*
Cross-Sectional Studies
Imaging, Three-Dimensional
Logistic Models
Middle Aged
Multidetector Computed Tomography
Odds Ratio
Plaque, Atherosclerotic
Predictive Value of Tests
Prospective Studies
Risk Assessment
Risk Factors
Severity of Illness Index
Ultrasonography, Doppler*
Vascular Calcification / diagnosis
Comment In:
JACC Cardiovasc Imaging. 2013 Jan;6(1):129-30   [PMID:  23328574 ]
JACC Cardiovasc Imaging. 2013 Jan;6(1):130   [PMID:  23328575 ]
Erratum In:
JACC Cardiovasc Imaging. 2013 Jan;6(1):131-2

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