Carotid Plaque/Intima-media Thickness Assessment OK in Routine Practice?
Carotid Plaque/Intima-media Thickness Assessment OK in Routine Practice?
Objectives: To describe the findings and evaluate appropriateness of a carotid artery study including the measurement of IMT, the presence of atherosclerotic plaque, and their correlation with cardiovascular risk factors.
Methods: 555 patients (220 men; 67.06 ± 12.44 years) were included in the study. 120 patients (21.62%) presented carotid plaque: 108 (19.45%) in patients with at least one risk factor and 12 (2.1%) in patients without risk factors. With respect to appropriateness of the present studies: 65% were appropriate, 22% were uncertain and 13% were inappropriate. The IMT medians were higher in males (0.0280; 95% CI, 00.82 to 0.478; p = 0.0057) and in hypertensive patients (0.391; 95% CI, 0.0190 to 0.0592; p = 0,001). There was a linear increase in mean IMT for each year increased in age (0.0059; 95% CI; 0.0050 to 0.0067). Carotid plaque was more frequent in patients with CAD (p = 0.0002), diabetes (p = 0.024) and hypertension (p = 0.036).
Conclusion: Assessment of carotid arteries identified increased incidence of plaque in patients with CAD, diabetes and hypertension. IMT was increased in older patients, hypertensive patients and males. Forty-five percent of the patients were studied based on uncertain and inappropriate reasons.
It has been proven that the atherosclerotic changes in the carotid artery mirror general atherosclerosis. Ultrasound measurements of IMT and plaque occurrence in the carotid arteries are important not only for the assessment of structural alterations but also because the extent of atherosclerosis in these vessels reflects the severity of arterial damage in other vascular territories. Epidemiological studies and clinical trials have shown that carotid artery intima-media thickness can identify prevalent and incident cardiovascular disease (CVD) events, and progression and regression of atherosclerosis. Intima-media thickness (IMT) of the carotid arteries is increasingly used in clinical trials as an important risk marker to investigate normal aging and preclinical atherosclerosis. Several studies demonstrated that carotid IMT is significantly associated with risk for myocardial infarction, stroke, death from coronary artery disease, or a combination of these events. Interestingly, in daily clinical practice, with the diffusion of knowledge and the education of public opinion, many physicians request carotid ultrasound studies even in patients without cardiovascular risk. We carried out this study to describe the findings and evaluate the appropriateness of carotid artery studies with ultrasound, including the measurement of ITM; the presence or not of atherosclerotic plaque; and their correlation with traditional cardiovascular risk factors in routine exams from our Doppler vascular laboratory.
Abstract and Introduction
Abstract
Objectives: To describe the findings and evaluate appropriateness of a carotid artery study including the measurement of IMT, the presence of atherosclerotic plaque, and their correlation with cardiovascular risk factors.
Methods: 555 patients (220 men; 67.06 ± 12.44 years) were included in the study. 120 patients (21.62%) presented carotid plaque: 108 (19.45%) in patients with at least one risk factor and 12 (2.1%) in patients without risk factors. With respect to appropriateness of the present studies: 65% were appropriate, 22% were uncertain and 13% were inappropriate. The IMT medians were higher in males (0.0280; 95% CI, 00.82 to 0.478; p = 0.0057) and in hypertensive patients (0.391; 95% CI, 0.0190 to 0.0592; p = 0,001). There was a linear increase in mean IMT for each year increased in age (0.0059; 95% CI; 0.0050 to 0.0067). Carotid plaque was more frequent in patients with CAD (p = 0.0002), diabetes (p = 0.024) and hypertension (p = 0.036).
Conclusion: Assessment of carotid arteries identified increased incidence of plaque in patients with CAD, diabetes and hypertension. IMT was increased in older patients, hypertensive patients and males. Forty-five percent of the patients were studied based on uncertain and inappropriate reasons.
Introduction
It has been proven that the atherosclerotic changes in the carotid artery mirror general atherosclerosis. Ultrasound measurements of IMT and plaque occurrence in the carotid arteries are important not only for the assessment of structural alterations but also because the extent of atherosclerosis in these vessels reflects the severity of arterial damage in other vascular territories. Epidemiological studies and clinical trials have shown that carotid artery intima-media thickness can identify prevalent and incident cardiovascular disease (CVD) events, and progression and regression of atherosclerosis. Intima-media thickness (IMT) of the carotid arteries is increasingly used in clinical trials as an important risk marker to investigate normal aging and preclinical atherosclerosis. Several studies demonstrated that carotid IMT is significantly associated with risk for myocardial infarction, stroke, death from coronary artery disease, or a combination of these events. Interestingly, in daily clinical practice, with the diffusion of knowledge and the education of public opinion, many physicians request carotid ultrasound studies even in patients without cardiovascular risk. We carried out this study to describe the findings and evaluate the appropriateness of carotid artery studies with ultrasound, including the measurement of ITM; the presence or not of atherosclerotic plaque; and their correlation with traditional cardiovascular risk factors in routine exams from our Doppler vascular laboratory.
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