Key result
Age, 10-year cardiovascular risk scores, and central blood pressure were associated with plaque presence and burden, while lipid ratios (e.g., LogTG/HDL > 0.135) indicated high lipid content.
Why the study?
There is no consensus on who would benefit from image screening to determine carotid and femoral atherosclerotic plaque presence, burden, and characteristics to improve cardiovascular risk stratification.
Observational (n=144)
Age, 10-year cardiovascular risk scores, and central blood pressure are strongly associated with atherosclerotic plaque presence and burden, suggesting their utility in guiding ultrasound screening in asymptomatic subjects.
Answers are grounded in this paper and cite their sources.
May aid CVR stratification via plaque imaging in asymptomatic subjects; leaves open optimal screening criteria.
Carotid and/or femoral atherosclerotic plaques (AP) assessment through imaging studies is an interesting strategy for improving individual cardiovascular risk (CVR) stratification and cardiovascular disease (CVD) and/or events prediction. There is no consensus on who would benefit from image screening aimed at determining AP presence, burden, and characteristics. AIMS: (1) to identify, in asymptomatic and non-treated subjects, demographic factors, anthropometric characteristics and cardiovascular risk factors (CRFs), individually or grouped (e.g., CVR equations, pro-atherogenic lipid ratios) associated with carotid and femoral AP presence, burden, geometry, and fibro-lipid content; (2) to identify cut-off values to be used when considering the variables as indicators of increased probability of AP presence, elevated atherosclerotic burden, and/or lipid content, in a selection scheme for subsequent image screening. METHODS: = 144 with AP; 47% females). Arterial (e.g., ultrasonography) and hemodynamic (central [cBP] and peripheral blood pressure; oscillometry/applanation tonometry) data were obtained. Carotid and femoral AP presence, burden (e.g., AP number, involved territories), geometric (area, width, height) and fibro-lipid content (semi-automatic, virtual histology analysis, grayscale analysis and color mapping) were assessed. Lipid profile was obtained. Lipid ratios (Total cholesterol/HDL-cholesterol, LDL-cholesterol/HDL-cholesterol, LogTryglicerides(TG)/HDL-cholesterol) and eight 10-years [y.]/CVR scores were quantified (e.g., Framingham Risk Scores [FRS] for CVD). RESULTS: Age, 10-y./CVR and cBP showed the highest levels of association with AP presence and burden. Individually, classical CRFs and lipid ratios showed almost no association with AP presence. 10-y./CVR levels, age and cBP enabled detecting AP with large surfaces (˃p75th). Lipid ratios showed the largest association with AP fibro-lipid content. Ultrasound evaluation could be considered in asymptomatic and non-treated subjects aiming at population screening of AP (e.g., ˃ 45 y.; 10-y./FRS-CVD ˃ 5-8%); identifying subjects with high atherosclerotic burden (e.g., ˃50 y., 10-y./FRS-CVD ˃ 13-15%) and/or with plaques with high lipid content (e.g., LogTG/HDL ˃ 0.135).
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Marin et al. (2020) conducted an observational in Asymptomatic and non-treated subjects (n=144). Cardiovascular risk factors, 10-year risk scores, and lipid ratios was evaluated on Carotid and femoral atherosclerotic plaque presence, burden, geometry, and fibro-lipid content. Age, 10-year cardiovascular risk scores, and central blood pressure were associated with plaque presence and burden, while lipid ratios (e.g., LogTG/HDL > 0.135) indicated high lipid content.
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