Key result
Statin therapy linked to ~22 percentage points fewer major events in advanced carotid atherosclerosis.
Why the study?
This study was conducted to provide an overview of carotid screening results for the prevention of cardiovascular disease.
Does carotid artery ultrasound measurement of total plaque area and early statin therapy improve risk prediction and reduce major adverse cardiovascular events or coronary revascularization in asymptomatic adults aged 20–65 years?
Observational (n=11,540)
Blinded ultrasound examination prior to coronary angiography in validation subcohort
Does carotid artery ultrasound measurement of total plaque area and early statin therapy improve risk prediction and reduce major adverse cardiovascular events or coronary revascularization in asymptomatic adults aged 20–65 years?
Absolute Event Rate: 16.1% vs 37.6%
Carotid ultrasound measurement of total plaque area and thickness identifies subclinical systemic atherosclerosis and significant coronary artery disease that classic risk scores miss, enabling targeted statin therapy associated with lower cardiovascular event rates.
Statin therapy was associated with lower events in advanced carotid plaque; extends observational support for ultrasound risk stratification but leaves open need for RCTs.
Background: This study provides an overview of the results of carotid screening for the prevention of cardiovascular disease. Methods: Between 2009 and 2026, 11,540 individuals, 45% of whom were women, aged 20–65 years without clinical signs of cardiovascular disease, underwent carotid ultrasound examinations. Over 8,800 follow-up examinations were also performed. The total plaque area (TPA) and maximum plaque thickness were measured. Results: TPA was presented as percentile curves according to age and sex. In a second cohort, age-related TPA thresholds for coronary stenosis ≥ 50% were determined. Advanced atherosclerosis (type III/IVb) is associated with a high risk of cardiovascular disease. Early treatment with statins improves the prognosis of these patients. The individual course of the disease with rapid progression of plaque burden could not be predicted based on classic risk factors. Of 75 patients with advanced atherosclerosis who suffered a myocardial infarction or ischemic stroke, 35% had a low PROCAM risk (< 10%) and only 27% had a high PROCAM risk. Mortality (from any cause) was significantly lower in men treated with statins. Conclusions: Measuring plaque burden in the carotid artery allows for a good estimation of an individual’s risk of a cardiovascular event. In this non-randomized observational study, statin treatment significantly improved the prognosis in subjects with advanced carotid artery atherosclerosis (type III-IVb findings on ultrasound).
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Adams et al. (2026) conducted an observational in Cardiovascular disease prevention / Carotid artery atherosclerosis (n=11,540). Carotid ultrasound plaque burden measurement (total plaque area and maximum plaque thickness) and statin therapy in advanced atherosclerosis vs. No statin therapy / traditional risk score assessment (PROCAM) was evaluated on Major adverse cardiovascular events (MACE), percutaneous transluminal coronary angioplasty (PTCA), or coronary artery bypass grafting (CABG) in individuals with advanced carotid atherosclerosis.
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