Ultrasound Markers that Describe Plaques Are More Sensitive than Mean Intima-Media Thickness in Patients with Familial Hypercholesterolemia

Ершова, А. И.; Балахонова, Т. В.; Мешков, А. Н.; Рожкова, Т. А.; Boytsov, S. А.

doi:10.1016/j.ultrasmedbio.2011.11.014

Cited by 18 publications

(16 citation statements)

References 22 publications

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“…Одновременно с этим накапливается данные о прогностической роли атеросклеротической бляшки (АСБ). В исследовании больных с семейной гиперхолестеринемией, для которых характерно ранее развитие атеросклеротического процесса, было показано, что именно ультразвуковые маркеры, характеризующие АСБ сонных артерий: количество АСБ, их суммарная высота, степень стеноза артерий, более информативны для оценки СС риска, чем ТИМ [5]. Согласно мета-анализу проспективных исследований [6] (2012), ультразвуковые параметры, характеризующие АСБ сонных склероза сонных и бедренных артерий.…”

Section: Introductionunclassified

Atherosclerotic plaque in carotid arteries as a risk marker for cardiovascular events risk in middle aged population

Ершова

Мешков

Деев

et al. 2018

Cardiovasc Ther Prev

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медицинский исследовательский центр профилактической медицины" Минздрава России. Москва; 2 ОБУЗ "Кардиологический диспансер" Минздрава России. Иваново; 3 ФГБУ "Национальный медицинский исследовательский центр кардиологии" Минздрава России. Москва, Россия Цель. Выявление ассоциации между степенью выраженности атеросклероза сонных артерий и сердечно-сосудистыми событиями в популяции лиц преимущественно среднего возраста. Материал и методы. В исследование вошли 1100 чел., участников исследования АТЕРОГЕН-Иваново (субисследования ЭССЕ-Иваново), в возрасте 40-67 лет. Все исследуемые прошли дуплексное сканирование сонных артерий (Samsung Medison MySono U6) с определением количества атеросклеротических бляшек (АСБ), максимального стеноза и суммарного стеноза и расчетом полоспецифических квинтилей. С помощью регрессионной модели Кокса был оценен риск наступления комбинированной конечной точки: смерть от любой причины, инфаркт миокарда, новый случай ишемической болезни сердца, острого нарушения мозгового кровообращения, реваскуляризация любого сосудистого бассейна. Медиана наблюдения-3,8 года. Результаты. АСБ были выявлены у 74,5% мужчин и 58,0% женщин. У мужчин атеросклероз был более выраженным, чем у женщин: максимальный стеноз составил 27 (0-34)% у мужчин vs 22 (0-58)% у женщин (р=0,000), суммарный стеноз-48 (0-90)% vs 22 (0-31)% (р=0,000) и количество бляшек-2 (0-3) vs 1(0-2) (р=0,000). Было зарегистрировано 24 документально подтвержденных конечных точек. 23 из 24 конечных точек произошли у лиц, у которых хотя бы один из исследуемых ультразвуковых маркеров соответствовал квинтилю ≥3. Регрессионный анализ показал, что если хотя бы один из ультразвуковых маркеров достиг квинтиля ≥3 (например, максимальный стеноз ≥25% у мужчин), то риск развития событий, вошедших в комбинированную конечную точку, увеличивается в 8,5 раз-95% ДИ 1,12-64,76 (p=0,039). В то же время ишемическая болезнь сердца в анамнезе увеличивает риск в 4,05 раза-95% ДИ 1,46-11,21 (p=0,007), острое нарушение мозгового крово обращения в 3,49 раз-95% ДИ 1,19-10,23 (p=0,023). Доля мужчин с АСБ и стенозом <25% составила 15%. Заключение. Наличие АСБ в сонных артериях в 8,5 раз увеличивает риск сердечно-сосудистых событий, при этом для 15% мужчин в популяции с АСБ в сонных артериях, сужающими просвет на <25%, требуется уточнение сердечно-сосудистого риска. Ключевые слова: атеросклеротическая бляшка, сонные артерии, ультразвуковые маркеры, стеноз. Конфликт интересов: не заявлен.

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Section: Introductionunclassified

Atherosclerotic plaque in carotid arteries as a risk marker for cardiovascular events risk in middle aged population

Ершова

Мешков

Деев

et al. 2018

Cardiovasc Ther Prev

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“…13,14 A review suggested that plaque score could predict coronary heart disease and might be more representative of atherosclerosis than mean IMT. 15 Furthermore, Ershova et al 16 reported that plaque number, plaque score and markers of percent area of stenosis were more sensitive than mean IMT for cardiovascular risk estimation in patients with familial hypercholesterolemia.…”

Section: Introductionmentioning

confidence: 99%

Carotid plaque score and intima media thickness as predictors of stroke and mortality in hypertensive patients

et al. 2013

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The mean intima media thickness (IMT) and plaque score from carotid ultrasonography are both widely used to evaluate macrovascular atherosclerotic change. The present study sought to examine which parameter more effectively predicts patient prognosis. This hospital-based cohort study included 356 patients with essential hypertension (mean age: 62.4 ± 0.6). We investigated how the mean IMT and plaque score correlated with various parameters, including pulse wave velocity (PWV), and we assessed the ability of the mean IMT and plaque score to predict cardiovascular events and total mortality. The mean IMT and plaque score significantly correlated with systemic atherosclerotic change, target organ damage, age and PWV. Subjects with a higher mean IMT and subjects with higher plaque scores showed higher frequencies of stroke and total mortality. In addition, subjects with marginal thickening of the intima media (mean ≥ 0.7) showed a significantly higher frequency of stroke than subjects with a mean IMT of <0.7. After adjustment for traditional risk factors, plaque score was significantly and independently predictive of stroke, and the predictive ability of the plaque score for the onset of stroke was equivalent to that of PWV. The mean IMT and plaque score showed a nonsignificant trend of higher risk of mortality after adjustment for traditional risk factors. The mean IMT and plaque score were significantly correlated with systemic atherosclerotic change. We revealed that plaque score predicted the onset of stroke more accurately than the mean IMT, and the accuracy of this prediction was equivalent to that from PWV in hypertensive patients. We also showed that marginal thickening of the intima media (as measured by mean IMT) may be a predictor of stroke.

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“…Total plaque area is now emerging as a better predictor of atherosclerotic disease and cardiovascular risk as compared to IMTcc [37,38], with researchers from the Trømso study reporting that the association between IMTc and myocardial infarction (MI), as well as first ischemic stroke [39] was weaker than between total plaque area and MI [40]. Adding to this, a recent meta-analysis has shown that assessment of carotid plaque had a higher diagnostic accuracy for the prediction of future coronary artery disease events compared with that of carotid IMT [41].…”

Section: Discussionmentioning

confidence: 99%

Association between presence of the metabolic syndrome and its components with carotid intima-media thickness and carotid and femoral plaque area: a population study

Panayiotou

Griffin²,

Kouis

et al. 2013

Diabetol Metab Syndr

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BackgroundWe aimed to explore the association between presence and number of components of the Metabolic Syndrome (MetS) and subclinical atherosclerosis outcomes (common carotid intima media thickness, plaque presence and sum of plaque area) in both the carotid and femoral bifurcations.MethodsCross-sectional analysis of 771 volunteers from the ongoing epidemiological Cyprus Study (46% male; mean age = 60.1 ± 9.8). (a) Carotid intima-media thickness (IMTcc), (b) sum of plaque area in the carotid bifurcations (sum of the largest plaques in each carotid bifurcation-SPAcar), (c) sum of plaque area in the femoral bifurcations (sum of the largest plaques in each femoral bifurcation-SPAfem) and (d) sum of plaque area in both carotid and femoral bifurcations (sum of the areas of the largest plaques present in each of the four bifurcations-SPA) were measured at baseline using ultrasound. Presence and number of components of the MetS was ascertained using the National Cholesterol Education Program ATPIII definition and their association tested using multivariable regression models.ResultsMetS was present in 259 (33.6%) individuals and was associated with a 0.02 mm increase in IMTcc (95% CI: 0.00 to 0.04, p = 0.047) after adjustment for age, sex, family history of CVD, alcohol consumption (BU/week) and smoking (pack-years). Each additional component of the MetS was associated with a 16% higher SPA (95% CI: 6.8% to 25.2%, pfor trend = 0.001), a 10% higher SPAcar (95% CI: 5% to 24%, pfor trend = 0.003) and a 14% higher SPAfem in the adjusted model.ConclusionsWe confirm an association between the MetS and IMTcc as well as report for the first time an association between the MetS and its components and femoral plaque area, in a general population over 40 years of age. Having any risk factors for the MetS increases the risk for subclinical atherosclerosis, with the risk increasing with each additional component. Using the dichotomous definition of the MetS may be overlooking the risk for subclinical atherosclerosis –and by inference future cardiovascular events- associated with having less than 3 risk factors.

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Ultrasound Markers that Describe Plaques Are More Sensitive than Mean Intima-Media Thickness in Patients with Familial Hypercholesterolemia

Cited by 18 publications

References 22 publications

Atherosclerotic plaque in carotid arteries as a risk marker for cardiovascular events risk in middle aged population

Atherosclerotic plaque in carotid arteries as a risk marker for cardiovascular events risk in middle aged population

Carotid plaque score and intima media thickness as predictors of stroke and mortality in hypertensive patients

Association between presence of the metabolic syndrome and its components with carotid intima-media thickness and carotid and femoral plaque area: a population study

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