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January 1, 2018Cardiology ResearchOpen Access

Early Diagnosis and Treatment of Coronary Heart Disease in Asymptomatic Subjects With Advanced Vascular Atherosclerosis of the Carotid Artery (Type III and IV b Findings Using Ultrasound) and Risk Factors

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Key result

Carotid ultrasound screening identifying advanced atherosclerosis (type III or IV b findings) predicted coronary stenosis ≥30% with a positive predictive value of 0.74.

Why the study?

Does carotid ultrasound screening identify asymptomatic subjects at high risk for significant coronary heart disease?

Population

6,008 healthy subjects aged 20-64 years from an occupational screening program. A subset of 43 asymptomatic…

Design

Cohort

Authors

AAAnsgar AdamsKoblenz University of Applied SciencesWBWaldemar BojaraKlinikum OsnabrückKSK. SchunkGemeinschaftsklinikum Mittelrhein

Discussion

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Overview

May identify high-risk asymptomatic subjects; hypothesis-generating for combined screening pending prospective validation.

Study Design

Type

Observational (n=6,008)

Multicenter

No

Structured PICO

Does carotid ultrasound screening identify asymptomatic subjects at high risk for significant coronary heart disease?

P
Population
6,008 healthy subjects (3,748 men, 2,260 women) aged 20-64 years from an occupational screening program. A subset of 43 asymptomatic subjects with advanced carotid atherosclerosis (type III or IV b findings on ultrasound) underwent further cardiac examinations including CT coronary angiography.
I
Intervention
Carotid ultrasound screening (measuring total plaque area and maximum plaque thickness) followed by CT coronary angiography for those with advanced atherosclerosis
O
Outcome
Presence and severity of coronary artery stenosis on CT coronary angiogramsurrogate

Main Result

Effect estimate: PPV 0.74 (95% CI 0.64-0.83)

Asymptomatic subjects with advanced carotid atherosclerosis on ultrasound have a high prevalence of significant coronary artery disease, suggesting utility for combined carotid and coronary screening.

Limitations

  • Only a small number of asymptomatic subjects were examined.

Cite This Study

Adams et al. (2018) conducted an observational in Coronary Heart Disease (n=6,008). Carotid ultrasound screening was evaluated on Positive predictive value for coronary stenosis ≥ 30% (PPV 0.74, 95% CI 0.64-0.83). Carotid ultrasound screening identifying advanced atherosclerosis (type III or IV b findings) predicted coronary stenosis ≥30% with a positive predictive value of 0.74.

synapsesocial.com/papers/6a14e3d3253bd9cd3ce627aahttps://doi.org/10.14740/cr667w

Topics

Coronary artery disease
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1A Negative Carotid Plaque Area Test Is Superior to Other Noninvasive Atherosclerosis Studies for Reducing the Likelihood of Having Underlying Significant Coronary Artery Disease2005 · 109 citations
  2. 2Carotid Atherosclerosis Is a Stronger Predictor of Myocardial Infarction in Women Than in Men2007 · 402 citations
  3. 3Carotid Plaque Area2002 · 583 citations
  4. 4Ultrasound in Cardiovascular Risk Prediction: Don't Forget the Plaque!2013 · 18 citations
  5. 5Carotid Plaque Area and Intima-Media Thickness in Prediction of First-Ever Ischemic Stroke2011 · 323 citations