Carotid Plaque Burden as a Measure of Subclinical Atherosclerosis Comparison With Other Tests for Subclinical Arterial Disease in the High Risk Plaque BioImage Study
Carotid Plaque Burden as a Measure of Subclinical Atherosclerosis Comparison With Other Tests for Subclinical Arterial Disease in the High Risk Plaque BioImage Study
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DOI：
10.1016/j.jcmg.2012.03.013
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发表时间：
2012-07-01
影响因子：
14
通讯作者：
Fuster, Valentin
中科院分区：
文献类型：
--
作者：
Sillesen, Henrik;Muntendam, Pieter;Fuster, Valentin
本研究的目的是比较无已知心血管疾病人群的颈动脉斑块负担、颈动脉内膜-中膜厚度（cIMT）、踝-肱指数（ABI）和腹主动脉直径（AAD）与冠状动脉钙评分（CACS）。背景危险因素预测心血管事件的临床应用是有限的。通过CACS、cIMT、颈动脉斑块负荷、AAD、ABI等无创检测检测亚临床动脉粥样硬化，其风险预测效果优于已建立的风险评分模型Framingham risk Score。方法高风险斑块生物成像研究调查了6.101名无症状患者，并报告了基线CACS、cIMT、ABI和AAD。此外，我们介绍了一种新的基于三维的超声方法的发现，在该方法中，颈动脉从颈部近端到尽可能远的横截面进行了研究。从所得的10-s视频中，斑块在横截面图像上被勾勒出来，所有斑块区域被总结为“斑块负担”。结果平均年龄为68.8岁，65.3%的受试者具有中等Framingham风险评分（10年风险为6% ~ 20%）。78%的患者发现颈动脉斑块，10%的患者发现ABI异常，28%的患者发现AAD bbbb20 mm， 68%的患者发现冠状动脉钙化。与cIMT（卡方24，p < 0.0001）、AAD（卡方2.9,p = 0.091）和ABI（卡方35.2,p < 0.0001）相比，颈动脉斑块负担与CACS（卡方450，p < 0.0001）的相关性更强。结论：在BioImage研究中，一种新的基于三维的超声方法比以前的研究发现了更多的颈动脉斑块。与其他方法相比，颈动脉斑块负荷是CACS最强的横断面预测指标，BioImage研究正在评估其作为未来心血管事件预测指标的临床应用。（BioImage Study: A Clinical Study of atherosclerosis Disease in A risk Population; NCT00738725） （J Am Coll Cardiol Img 2012;5:681-9） (C) 2012 by American College of Cardiology Foundation
OBJECTIVES The purpose of this study was to compare carotid plaque burden, carotid intima-media thickness (cIMT), ankle-brachial index (ABI), and abdominal aortic diameter (AAD) to coronary artery calcium score (CACS) in people without known cardiovascular disease.BACKGROUND The clinical utility of risk factors to predict cardiovascular events is limited. Detection of subclinical atherosclerosis by noninvasive tests such as CACS, cIMT, carotid plaque burden, AAD, and ABI may improve risk prediction above that of established risk scoring models, namely, Framingham Risk Score.METHODS The High Risk Plaque BioImage study investigated 6.101 asymptomatic persons and reports baseline CACS, cIMT, ABI, and AAD. In addition, we present findings from a new 3-dimensional-based ultrasound approach, where the carotid artery was investigated in cross section from proximal in the neck to as distal as possible. From the resulting 10-s video, plaque was outlined on cross-sectional images and all plaque areas were summarized into "plaque burden."RESULTS The mean age was 68.8 years, and 65.3% of subjects had intermediate Framingham Risk Score (6% to 20% 10-year risk). Carotid plaques were identified in 78% of cases, abnormal ABI in 10%, AAD >20 mm in 28%, and coronary calcium in 68% of participants. Carotid plaque burden was found to correlate stronger with CACS (chi-square 450, p < 0.0001) than did cIMT (chi-square 24, p < 0.0001), AAD (chi-square 2.9, p = 0.091), and ABI (chi-square 35.2, p < 0.0001).CONCLUSIONS In the BioImage study, a new 3-dimensional-based ultrasound method identified more carotid plaques than in previous studies. Compared to other methods, carotid plaque burden was the strongest cross-sectional predictor of CACS, and its clinical utility as predictor of future cardiovascular events is being evaluated in the BioImage study. (BioImage Study: A Clinical Study of Burden of Atherosclerotic Disease in an At-Risk Population; NCT00738725) (J Am Coll Cardiol Img 2012;5:681-9) (C) 2012 by the American College of Cardiology Foundation