Key result
Carotid ultrasound assessment of IMT and plaque improves cardiovascular risk stratification over standard scores.
Direct visualization of subclinical atherosclerosis improves individual cardiovascular risk stratification beyond traditional scoring systems.
May refine risk stratification beyond scores; leaves open prospective outcome trials before practice change.
Cardiovascular risk (CVR) stratification plays an important role in the primary prevention of atherosclerosis and associated disorders. The standard scales for CVR assessment (Framingham scale, SCORE scale, etc.) are focused on a limited number of traditional risk factors (RFs) and, therefore, neither produce precise individual risk estimates, nor increase the effectiveness of preventive interventions. One of the methods for CVR assessment optimisation is the diagnostics of subclinical atherosclerosis, based on the direct visualisation of preclinical atherosclerotic changes in arterial wall. Extracranial carotid artery (CA) ultrasound and assessment of the intima-media thickness (IMT) index or atherosclerotic plaque volume (PV) is an important method of the preclinical atherosclerosis diagnostics. The review discusses pathogenetic mechanisms of IMT increase, the standards of ultrasound IMT assessment and its interpretation, and the role of the information obtained for optimization of the CVR evaluation.
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Katamadze et al. (2012) conducted a review in Subclinical atherosclerosis. Subclinical atherosclerosis diagnostics (carotid ultrasound for intima-media thickness and plaque volume) vs. Standard cardiovascular risk assessment scales (e.g., Framingham, SCORE) was evaluated. Direct visualization of preclinical atherosclerotic changes via carotid ultrasound assessment of intima-media thickness and plaque volume improves individual cardiovascular risk stratification.
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