Carotid plaque burden as a measure of subclinical atherosclerosis: Comparison with other tests for subclinical arterial disease in the high risk plaque bioimage study

Henrik Sillesen, Pieter Muntendam, Aram Adourian, Robert Entrekin, Mario J. Garcia, Erling Falk, Valentin Fuster

Research output: Contribution to journalArticle

134 Citations (Scopus)

Abstract

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)

Original languageEnglish (US)
Pages (from-to)681-689
Number of pages9
JournalJACC: Cardiovascular Imaging
Volume5
Issue number7
DOIs
StatePublished - Jul 2012

Fingerprint

Ankle Brachial Index
Atherosclerosis
Carotid Intima-Media Thickness
Coronary Vessels
Calcium
Carotid Arteries
Neck
Cardiovascular Diseases

Keywords

  • ABI
  • aortic diameter
  • cardiovascular disease
  • cardiovascular risk prediction
  • carotid plaque
  • coronary calcium
  • IMT

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

Carotid plaque burden as a measure of subclinical atherosclerosis : Comparison with other tests for subclinical arterial disease in the high risk plaque bioimage study. / Sillesen, Henrik; Muntendam, Pieter; Adourian, Aram; Entrekin, Robert; Garcia, Mario J.; Falk, Erling; Fuster, Valentin.

In: JACC: Cardiovascular Imaging, Vol. 5, No. 7, 07.2012, p. 681-689.

Research output: Contribution to journalArticle

Sillesen, Henrik ; Muntendam, Pieter ; Adourian, Aram ; Entrekin, Robert ; Garcia, Mario J. ; Falk, Erling ; Fuster, Valentin. / Carotid plaque burden as a measure of subclinical atherosclerosis : Comparison with other tests for subclinical arterial disease in the high risk plaque bioimage study. In: JACC: Cardiovascular Imaging. 2012 ; Vol. 5, No. 7. pp. 681-689.
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AU - Garcia, Mario J.

AU - Falk, Erling

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