Format

Send to

Choose Destination
Int J Cardiol. 2019 Jun 17. pii: S0167-5273(19)30016-6. doi: 10.1016/j.ijcard.2019.06.038. [Epub ahead of print]

The prognostic value of various carotid ultrasound parameters in patients at high and very high cardiovascular risk.

Author information

1
Department of Internal Medicine, Federal State Budgetary Educational Institution of Higher Education "South-Ural State Medical University" of the Ministry of Healthcare of the Russian Federation, Vorovskogo st. 64, 454092 Chelyabinsk, Russia.. Electronic address: henkel-07@mail.ru.
2
Department of Hospital Therapy, Federal State Budgetary Educational Institution of Higher Education "South-Ural State Medical University" of the Ministry of Healthcare of the Russian Federation, Vorovskogo st. 64, 454092 Chelyabinsk, Russia.
3
Central Research Laboratory, Federal State Budgetary Educational Institution of Higher Education "South-Ural State Medical University" of the Ministry of Healthcare of the Russian Federation, Vorovskogo st. 64, 454092 Chelyabinsk, Russia.
4
Department of Internal Medicine, Federal State Budgetary Educational Institution of Higher Education "South-Ural State Medical University" of the Ministry of Healthcare of the Russian Federation, Vorovskogo st. 64, 454092 Chelyabinsk, Russia.

Abstract

BACKGROUND:

According to the current guidelines the visualization of atherosclerotic plaques in the carotid arteries is the only option that carotid ultrasound provides for the assessment of cardiovascular risk (CVR). The direction devoted to the development and implementation of markers based on the quantification of atheroma, is promising. The aim of the study was to evaluate the prognostic value of various carotid ultrasound parameters in patients at high and very high CVR.

METHODS:

Patients at high and very high CVR were included. All patients underwent carotid ultrasound. We evaluated carotid intima-media thickness (cIMT), carotid plaque, carotid plaque score (cPS) and carotid total plaque area (cTPA). The combined endpoint was cardiovascular death, non-fatal myocardial infarction or unstable angina, non-fatal stroke and coronary revascularization.

RESULTS:

The study included 100 patients. The duration of the follow-up period was 24.4 (14.1-34.3) months. Endpoint events occurred in 34.0% patients. cIMT and cPS were not significantly associated with the risk of cardiovascular events. The presence of carotid plaque in accordance with Cox regression after adjusting for possible confounders was associated with an increase in the relative risk of cardiovascular events by 10.5 times (95% CI 1.27-86.5; p = 0.008). CTPA ≥69 mm2 according to adjusted analysis was associated with an increase in the risk of cardiovascular events by 5.86 times (95% CI 2.09-16.4; p = 0.001).

CONCLUSION:

In patients at high and very high CVR among carotid atherosclerosis markers only carotid plaque and cTPA had an independent predictive value regarding the development of adverse cardiovascular events.

KEYWORDS:

Cardiovascular outcomes; Carotid atherosclerosis; Carotid plaque; Carotid ultrasound; Plaque score; Total plaque area

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center