Ultrasound-detected carotid plaque as a screening tool for advanced subclinical atherosclerosis.
ABSTRACT There is great need for a simple, noninvasive tool that can be used in an office setting to screen for subclinical atherosclerosis. In patients referred for cardiovascular (CV) risk assessment, we evaluated the ability of ultrasound screening for carotid plaque to identify patients with advanced subclinical atherosclerosis.
Consecutive asymptomatic patients without vascular disease referred by their physician for measurement of the ankle-brachial pressure index and carotid intima-media thickness (CIMT) were included. Carotid intima-media thickness was measured using the standardized ultrasound protocol from the Atherosclerosis Risk in Communities (ARIC) study. Advanced atherosclerosis was defined as CIMT > or = 75th percentile for age, sex, and race in ARIC.
The mean age of the 327 subjects was 55.4 years (SD 7.7 years). The 10-year Framingham CV risk was 5.1% (4.8%). In a multiple logistic regression model that included Framingham CV risk, ankle-brachial pressure index, and use of lipid-lowering medications, plaque presence significantly predicted advanced atherosclerosis (odds ratio 3.08, 95% CI 1.91-4.96, P < .001). In stepwise regression models that included age, body mass index, current tobacco use, family history of premature CV disease, fasting glucose, sex, systolic blood pressure, total/high-density lipoprotein cholesterol ratio, and use of antihypertensive and lipid-lowering medications, plaque presence independently predicted advanced atherosclerosis (P < .001).
Ultrasound detection of carotid plaque helped identify asymptomatic patients with advanced subclinical atherosclerosis. Screening for carotid plaque is easier than determination of CIMT and may help detect asymptomatic patients at increased CV risk.
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ABSTRACT: Objectives Retired National Football League (NFL) players were reported to have high prevalence of cardiovascular risk factors. Lipoprotein Associated Phospholipase A2 (LpPLA2) has shown to be associated with cardiovascular disease in the general population, but it is unknown whether such an association exists in retired NFL players. Our objective was to assess whether LpPLA2 mass was associated with coronary artery calcium (CAC) and carotid artery plaque (CAP) in retired NFL players. Methods LpPLA2 mass was assessed using a dual monoclonal antibody immunoassay. CAC presence was defined as CAC score>0. CAP was defined as focal thickening ≥50% than that of the surrounding vessel wall with a minimal thickness of 1.2 mm on carotid ultrasound. Results In 832 NFL players, the median (IQR) age and LpPLA2 levels were 54 (45–63) years and 142 (109–181) ng/mL respectively. LpPLA2 mass was positively correlated with low-density lipoprotein (LDL) cholesterol and high-density lipoprotein cholesterol; negatively correlated with LDL particle concentration and body mass index; and not correlated with high-sensitivity C-reactive protein. CAC was present in 659 (79%) and CAP in 544 (65%) players. In a fully adjusted model, LpPLA2 was not associated with CAC (OR per 1-SD increase, 0.85; 95% CI 0.71–1.02) or CAP (0.90, 0.75–1.08). LpPLA2 was also not associated with CAC burden in those with CAC>0. Results were similar when highest and lowest LpPLA2 tertiles were compared, and also in various subgroups. Conclusion LpPLA2 mass was not associated with coronary or carotid subclinical atherosclerosis in retired NFL players.Atherosclerosis 10/2014; 236(2):251–256. DOI:10.1016/j.atherosclerosis.2014.07.011 · 3.97 Impact Factor
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ABSTRACT: To investigate the association of carotid artery calcification (CAC) on panoramic radiographs and determine carotid artery atherosclerosis with ultrasonography. The study included 4050 subjects aged 50 years and older. Panoramic radiographs for the presence of CAC were interpreted. Common carotid artery intima-media thickness (CCA-IMT), carotid bulb IMT (CB-IMT), carotid plaques, and the diameter of the common carotid artery (CCA-diameter) were measured by using ultrasonography. CB-IMT was significantly greater in male subjects with CAC than in those without CAC. CCA-diameter was significantly greater in subjects with CAC than in those without CAC in both genders. However, there was no significant difference in CCA-IMT. CAC was associated with carotid plaque (for men, odds ratio [OR] 2.14; 95% confidence interval [CI] 1.01-3.36; for women, OR 1.19; 95% CI 0.84-1.67). CAC on panoramic radiographs was positively associated with IMT and plaque in men and positively associated with carotid diameter in both sexes. CAC on panoramic radiographs was positively associated with carotid atherosclerosis. Copyright © 2014 Elsevier Inc. All rights reserved.Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology 12/2014; 118(6):739-45. DOI:10.1016/j.oooo.2014.09.011 · 1.46 Impact Factor