Abstract 11033: Monoarterial Cardiovascular Screening: A 10-year Follow-up Study. San Valentino Cardiovascular Screening Project
The cardiovascular screening method developed for the Cardiovascular Screening project in San Valentino has used for more than 20 years, high-resolution ultrasound scanning of both carotid and femoral arteries bifurcations and of the abdominal aorta. This method is simple, cost-effective and has been validated by long-term (>10-year follow up) studies. A simplified version of this screening - the mono-artery screening (1AS), can be done in less time (2-4 minutes), cheaply and without the need to undress patients. It is possible even in working places or, i.e., in a pharmacy. This study evaluated 12.544 non-clinical subjects (age range 45-55); these subjects were followed up within the cardiovascular screening program in San Valentino. One of the carotid bifurcations was scanned with high-res ultrasound. Four arterial classes were defined: 1: normal bifurcation; 2: IMT thichening (considering normal, for our population, IMT <0.4 mm for subjects aging 40-50 and IMT < 0.5 for those aging 51 to 60. 3: 'minimal' plaques (<30% lumen stenosis; homogeneous, high echogenicity; no calcifications); 4: advanced plaques (31-60% stenosis; dishomogeneous echogenicity; even minor, initial calcifications; plaque complexity with irregular lumen border). RESULTS. Class 1 included 82% of the population (women 65%). In this class atherosclerosis-related event rate (strokes, myocardial infarctions, peripheral vascular disease,hospital admissions) at 10 years was <0.5%. Class 2 included 11% of the subjects (event rate = 1%); Class 3 included 5% of subjects (event rate 5%; Class 4 included only 2% of the subjects (event rate 17.6%). No significant action was tahen in class 1-2 subjects (only general education and lifestyle suggestions); class 3 and 4 were included in a careful follow up (no treatment in class 3; preventive treatment according to risk factors in Class 4). Treatments, if needed, were decided by GPs in class 4. CONCLUSIONS: 1AS is less precise that 5 arteries screening (missing some significant information in less than 5% of patients) but it is fast and cheap and it could be effective in excluding subjects without significant risks from more expensive follow up programs. 1AS has also a significant educational value for patients at risk of atherosclerosis.
- © 2012 by American Heart Association, Inc.