Document Detail

Evidence of carotid atherosclerosis in orthopantomograms and the risk for future cardiovascular events.
MedLine Citation:
PMID:  21104618     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Evidence of carotid atherosclerosis can be detected in 3 to 5% of orthopantomogram (OPG) investigations. The clinical impact of these findings is unknown. We investigated the association of OPG findings of carotid atherosclerosis with the occurrence of future cardiovascular adverse events.
PATIENTS AND METHODS: We randomly selected 411 of 1268 participants with pre-existent cardiovascular disease from the prospective Inflammation in Carotid Arteries Risk for Arthrosclerosis Study (ICARAS) and assessed their OPGs for the presence of calcified atherosclerotic lesions or indirect signs of atherosclerosis, such as surgical clips or intravascular stents. The degree of carotid stenosis was measured by duplex ultrasound investigations. Patients were then followed for median 39 months (interquartile range 33 to 44 months) for the occurrence of major adverse cardiovascular events (MACE) including myocardial infarction, coronary revascularisation, stroke and death.
RESULTS: We found no statistically significant association between the presence of carotid atherosclerosis detected on OPGs and the presence of a significant carotid stenosis (left carotid artery kappa=0.08; right carotid artery kappa=0.12), or the degree of carotid stenosis (P=0.20). Furthermore, the presence of OPG signs of carotid atherosclerosis was not statistically significant associated with future MACE (adjusted hazard ratio 0.92, 95% confidence interval 0.59 to 1.42; P=0.70).
CONCLUSIONS: Evidence of carotid plaque revealed by OPGs in patients with previously known cardiovascular disease is no useful prognostic marker for MACE. Detection of carotid atherosclerosis by OPGs in these patients therefore has no clinical consequence.
M Hoke; B Schmidt; T Schillinger; W Kluger; F Wiesbauer; W Mlekusch; E Minar; M Schillinger
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  VASA. Zeitschrift für Gefässkrankheiten     Volume:  39     ISSN:  0301-1526     ISO Abbreviation:  VASA     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-24     Completed Date:  2011-01-14     Revised Date:  2012-10-19    
Medline Journal Info:
Nlm Unique ID:  0317051     Medline TA:  Vasa     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  298-304     Citation Subset:  IM    
General Hospital Vienna, Internal Medicine II/Angiology, Medical University Vienna, Vienna, Austria.
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MeSH Terms
Cardiovascular Diseases / etiology*,  mortality
Carotid Artery Diseases / complications,  mortality,  radiography*,  ultrasonography
Carotid Stenosis / complications,  mortality,  radiography*,  ultrasonography
Chi-Square Distribution
Kaplan-Meier Estimate
Middle Aged
Predictive Value of Tests
Proportional Hazards Models
Prospective Studies
Radiography, Panoramic*
Risk Assessment
Risk Factors
Severity of Illness Index
Time Factors
Ultrasonography, Doppler, Duplex
Comment In:
Vasa. 2011 Jan;40(1):82-3; athor reply 84   [PMID:  21283979 ]

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