Key result
3DVUS shows ~2.5-fold higher plaque burden in men vs. women and independently tracks CV risk.
Why the study?
Detection of subclinical atherosclerosis improves risk prediction beyond cardiovascular risk factors and risk scores, and volumetric quantification of plaque burden by 3-dimensional vascular ultrasound may provide further added value over simple plaque detection.
Does 3-dimensional vascular ultrasound (3DVUS) quantification of plaque burden improve the assessment of estimated 10-year cardiovascular risk compared to simple plaque detection in mid-life adults?
Observational (n=3,860)
Does 3-dimensional vascular ultrasound (3DVUS) quantification of plaque burden improve the assessment of estimated 10-year cardiovascular risk compared to simple plaque detection in mid-life adults?
Volumetric quantification of subclinical atherosclerosis via 3D vascular ultrasound correlates strongly with cardiovascular risk factors—particularly in the femoral territory—and reflects estimated 10-year cardiovascular risk more closely than simple plaque detection alone.
3DVUS plaque burden quantification may refine CV risk prediction beyond plaque detection; hypothesis-generating and requires prospective outcome validation before practice change.
Background Detection of subclinical atherosclerosis improves risk prediction beyond cardiovascular risk factors (CVRFs) and risk scores, but quantification of plaque burden may improve it further. Novel 3-dimensional vascular ultrasound (3DVUS) provides accurate volumetric quantification of plaque burden. Objectives The authors evaluated associations between 3DVUS-based plaque burden and CVRFs and explored potential added value over simple plaque detection. Methods The authors included 3,860 (92.2%) PESA (Progression of Early Subclinical Atherosclerosis) study participants (age 45.8 ± 4.3 years; 63% men). Bilateral carotid and femoral territories were explored by 3DVUS to determine the number of plaques and territories affected, and to quantify global plaque burden defined as the sum of all plaque volumes. Linear regression and proportional odds models were used to evaluate associations of plaque burden with CVRFs and estimated 10-year cardiovascular risk. Results Plaque burden was higher in men (63.4 mm3 [interquartile range (IQR): 23.8 to 144.8 mm3] vs. 25.7 mm3 [IQR: 11.5 to 61.6 mm3] in women; p < 0.001), in the femoral territory (64 mm3 [IQR: 27.6 to 140.5 mm3] vs. 23.1 mm3 [IQR: 9.9 to 48.7 mm3] in the carotid territory; p < 0.001), and with increasing age (p < 0.001). Age, sex, smoking, and dyslipidemia were more strongly associated with femoral than with carotid disease burden, whereas hypertension and diabetes showed no territorial differences. Plaque burden was directly associated with estimated cardiovascular risk independently of the number of plaques or territories affected (p < 0.01). Conclusions 3DVUS quantifies higher plaque burden in men, in the femoral territory, and with increasing age during midlife. Plaque burden correlates strongly with CVRFs, especially at the femoral level, and reflects estimated cardiovascular risk more closely than plaque detection alone. (Progression of Early Subclinical Atherosclerosis [PESA] Study; NCT01410318).
No takes yet. Share an insight, caveat, or question.
López‐Melgar et al. (2017) conducted an observational in Subclinical atherosclerosis (n=3,860). 3-dimensional vascular ultrasound (3DVUS) plaque burden quantification vs. Simple plaque detection (number of plaques or territories affected) was evaluated on Global plaque burden (sum of all plaque volumes in mm3) and association with cardiovascular risk factors and estimated 10-year cardiovascular risk (p=<0.001). 3DVUS plaque burden was higher in men vs women (63.4 vs 25.7 mm3; p<0.001) and femoral vs carotid territories (64 vs 23.1 mm3; p<0.001), associating independently with CV risk (p<0.01).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: