Key result
Subclinical atherosclerosis increased cardiovascular event incidence from 4%, 14%, and 20% to 35%, 46%, and 63% across baseline risk profiles in asymptomatic patients >45 years.
Why the study?
Does the presence of subclinical atherosclerosis on carotid ultrasound improve cardiovascular risk prediction in asymptomatic patients >45 years with risk factors?
Cohort (n=558)
Does the presence of subclinical atherosclerosis on carotid ultrasound improve cardiovascular risk prediction in asymptomatic patients >45 years with risk factors?
Subclinical atherosclerosis detected by carotid ultrasound significantly improves cardiovascular risk stratification in asymptomatic patients over 45 with risk factors.
May refine risk stratification in asymptomatic patients >45; leaves open whether carotid ultrasound screening alters outcomes in trials.
AIM: To show that subclinical atherosclerosis (subclinical-ATS) of carotid arteries [intima-media thickness (IMT) or asymptomatic carotid plaque (ACP)], may provide additional information for risk stratification, in asymptomatic patients, aged greater than 45 years, with a cluster of risk factors (RFs). METHODS AND RESULTS: We studied 558 asymptomatic patients (235 males). RFs for atherosclerosis were assessed and the 10-year-risk was calculated according to the Italian risk score. Doppler ultrasound of carotid arteries identified the presence of IMT greater than 0.9 mm in 183 patients and ACP in 147 patients. One hundred and fifty-three patients developed cerebrovascular or cardiovascular (CV) events in the follow-up: 67 developed acute myocardial infarction, 39 developed angina, 25 had a stroke or transient ischemic attack, six died for CV events, and 16 underwent percutaneous or surgical revascularization. The incidence reflected the different risk profiles (4, 14, and 20%, respectively). However, in patients with baseline subclinical-ATS the incidence of events increased to 35, 46, and 63%, respectively. In the multivariate analysis the incidence of events was significantly influenced by the presence of asymptomatic carotid lesions in each risk category. CONCLUSION: In our experience, the incidence of CV events is enhanced in patients with subclinical-ATS. Increased IMT and ACP predict CV events and improve the risk stratification of asymptomatic patients aged greater than 45 years and with a cluster of RFs, in a long-term follow-up.
No takes yet. Share an insight, caveat, or question.
Novo et al. (2010) conducted a cohort in Asymptomatic patients with cardiovascular risk factors (n=558). Subclinical atherosclerosis (IMT >0.9 mm or asymptomatic carotid plaque) vs. No baseline subclinical atherosclerosis was evaluated on Cerebrovascular or cardiovascular events. Subclinical atherosclerosis increased cardiovascular event incidence from 4%, 14%, and 20% to 35%, 46%, and 63% across baseline risk profiles in asymptomatic patients >45 years.