Abstract 19025: A Novel 3D Approach to Screen for Subclinical Atherosclerosis Using Carotid Ultrasound - Results of the BioImage High Risk Plaque Study
Introduction: Carotid IMT and plaque are predictors for cardiovascular events. Rather than scanning longitudinally, we scanned in cross-sectional mode along the axis of the carotid artery Resultsing in a 3D-like evaluation.
Hypothesis: Cross-sectional scanning of the carotid arteries by ultrasound may provide additional information on subclinical atherosclerosis to improve identification and potential prediction of atherothrombotic events.
Methods: The BioImage study enrolled 7,687 subjects (55–80 years) without known prior cardiovascular disease. Of these 6,104 underwent longitudinal and cross-sectional scanning of the carotid artery and coronary artery calcium scoring (CACS). Carotid plaque was defined according to current consensus. The presented ultrasound data represents 4.671 cases read at submission.
Results: Bilateral carotid plaque was present in 59.1% of males and 45.4% of females and strongly correlated with age. Plaques were generally small in size with an average thickness of 2.1mm (SD: +/− 0.9). Despite the high prevalence of plaque, clinically significant stenosis exceeding 50% was rare (3.6%). Although plaque presence showed a correlation with IMT, 42.7% of subjects with normal IMT (=<0.80mm), were found to have bilateral plaque and only 25.2% had no plaque. Similarly for CACS, although a strong correlation was observed 35.6% of subjects with a CACS of less than 10 were found to have bilateral plaque and only 31.4% were found to have no carotid plaque. Plaque presence was observed in 44.6% of individuals with a 10-year Framingham Risk Score of 10% or less (low risk) and 67.1% of individuals with a Framingham Risk Score of 20% or more (high risk).
Conclusions: Cross-sectional carotid scanning resulted in a remarkably high percentage of subjects who were found to have bilateral plaque including persons with normal IMT and CACS. Further analysis of plaque features may provide valuable information for improved prediction of cardiovascular events.
- © 2010 by American Heart Association, Inc.