Carotid Ultrasound Identifies High Risk Subclinical Atherosclerosis in Adults With Low Framingham Risk Scores

Eleid, Mackram F.; Lester, Steven J.; Wiedenbeck, Troy L.; Patel, S.H.; Appleton, Christopher P.; Nelson, Matthew R.; Humphries, Julie; Hurst, R. Todd

doi:10.1016/s0735-1097(10)60893-5

Cited by 5 publications

(6 citation statements)

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“…However, a recently published systematic review and other guidelines are in favor of imaging subclinical atherosclerosis to help improve risk stratification for CAD. 18,22,23 The study by Eleid et al 24 supports this having established that 38% of asymptomatic young and middleaged population with low (<5%) Framingham risk estimate (FRE) score have abnormal high-risk carotid US findings associated with increased risk of CV events.…”

Section: Discussionmentioning

confidence: 82%

Carotid Intimal Thickness and Plaque Predict Prevalence and Severity of Coronary Atherosclerosis

et al. 2014

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We determined whether increased carotid intima-media thickness (cIMT) and prevalence of carotid plaque (CP) are predictive of prevalence and severity of coronary atherosclerosis. Consecutive patients (n = 150) with no history of coronary artery disease (CAD), who underwent both carotid ultrasound and computed tomographic coronary angiography, were included in the analysis. The mean cIMT was higher in patients with CAD than in those without CAD (0.76 vs 0.66 mm, P < .003). In a logistic regression analysis, diabetes (P = .03) and CP (P = .02) were associated with significant coronary plaque. Backward selection analysis (after removing nonsignificant variables) showed higher mean cIMT measurement correlated well with prevalence of any coronary plaque (P = .03) and obstructive coronary plaque disease (P = .05), whereas presence of CP was a good predictor of both obstructive (>50% stenosis P = .003) and any coronary plaque (P = .003). In conclusion, CP and cIMT can be useful predictors of prevalence of CAD and its severity.

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Section: Discussionmentioning

confidence: 82%

Carotid Intimal Thickness and Plaque Predict Prevalence and Severity of Coronary Atherosclerosis

et al. 2014

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“…The prevalence of significant carotid stenosis is low in the general population, but up to as high as 38% of individuals younger than 65 years classified as low-risk according to FRS were shown to have abnormal carotid ultrasound findings, which are associated with an increased risk of cardiovascular events. (17) Therefore carotid screening could potentially improve population health in several ways:…”

Section: Population Screening For Asymptomatic Carotid Stenosismentioning

confidence: 99%

Asymptomatic carotid artery stenosis: who should be screened, who should be treated and how should we treat them?

Waard¹,

Morris²,

Borst³

et al. 2017

J Cardiovasc Surg

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Although stopping smoking, lowering blood pressure and reducing lipid levels will reduce global stroke risk and cardiovascular mortality, these remain leading causes of death and disability especially in ageing populations. Further prevention strategies are needed and, in the first part of this review, we explore the potential benefits of appropriate screening for carotid artery disease to reduce stroke and identify those who may have related cardiac disease. Although whole-population carotid screening is an inefficient and costly means of identifying candidates with tight carotid stenosis who might warrant intervention, it can identify many people with lower levels of stenosis who may benefit from cardiovascular riskreducing medications. Longer-term benefits and cost-effectiveness of any targeted screening programme needs further evaluation.Patients with carotid stenosis are known to be at increased risk of stroke and vascular death.Whilst randomised clinical trials and guidelines have reported stroke hazards and benefits of interventional treatment for carotid stenosis, uncertainty remains about their optimal medical management. In the second part of this review we discuss Level I evidence for medical and surgical treatment of asymptomatic carotid stenosis, reasons for the current lack of consensus on interventional management of these patients and future studies which may help to clarify which groups will (and which will likely not) benefit from interventions.

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“…In one study, patients 65 years and younger without diabetes mellitus who were not taking statins underwent ultrasonography to assess carotid intima-media thickness. 36 Of 441 patients, 336 had a lowrisk Framingham score (5% risk of cardiovascular disease within 10 years), but 38% of this group had increased carotid intima-media thickness on ultrasonography, which has been shown to predict a higher risk of future MI in several studies. 37,38 In light of these findings, the preventive regimens were intensified in 70% of this apparently low-risk group through initiation of lipid-lowering therapy, aspirin, or both.…”

Section: Risk Factors For Scdmentioning

confidence: 99%

“…In keeping with the National Cholesterol Education Program guidelines, only 4.7% of patients with a low Framingham score in this study would have been candidates for lipid-lowering therapy. 36 Traditional Risk Factors Traditional risk factors remain important predictors of SCD both in the primary care setting and after MI. These factors include older age, male sex, a personal history of hypertension, diabetes mellitus, and dyslipidemia, a family history of premature CAD, and current or past smoking.…”

Section: Risk Factors For Scdmentioning

confidence: 99%

Sudden Cardiac Death From the Perspective of Coronary Artery Disease

Sara

Eleid

Gulati

et al. 2014

Mayo Clinic Proceedings

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Sudden cardiac death accounts for approximately 50% of all deaths attributed to cardiovascular disease in the United States. It is most commonly associated with coronary artery disease and can be its initial manifestation or may occur in the period after an acute myocardial infarction. Decreasing the rate of sudden cardiac death requires the identification and treatment of at-risk patients through evidence-based pharmacotherapy and interventional strategies aimed at primary and secondary prevention. For this review, we searched PubMed for potentially relevant articles published from January 1, 1970, through March 1, 2014, using the following key search terms: sudden cardiac death, ischemic heart disease, coronary artery disease, myocardial infarction, and cardiac arrest. Searches were enhanced by scanning bibliographies of identified articles, and those deemed relevant were selected for full-text review. This review outlines various mechanisms for sudden cardiac death in the setting of coronary artery disease, describes risk factors for sudden cardiac death, explores the management of cardiac arrest, and outlines optimal practice for the monitoring and treatment of patients after an acute ST-segment elevation myocardial infarction to decrease the risk of sudden death.

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Carotid Ultrasound Identifies High Risk Subclinical Atherosclerosis in Adults With Low Framingham Risk Scores

Cited by 5 publications

References 0 publications

Carotid Intimal Thickness and Plaque Predict Prevalence and Severity of Coronary Atherosclerosis

Carotid Intimal Thickness and Plaque Predict Prevalence and Severity of Coronary Atherosclerosis

Asymptomatic carotid artery stenosis: who should be screened, who should be treated and how should we treat them?

Sudden Cardiac Death From the Perspective of Coronary Artery Disease

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