Abstract 19548: Detection, Correlation and Prediction of Systemic Vascular Disease using 3D volumetric Carotid Ultrasound: Results from the High Risk Plaque Initiative
Purpose We sought to determine the prevalence and clinical correlates of carotid atherosclerosis using novel 3D ultrasound imaging.
Methods In the High-Risk Plaque (HRP) Initiative, 3690 asymptomatic, at-risk adults underwent non-invasive imaging for evaluation of subclinical atherosclerosis in the carotid arteries using duplex ultrasound for measurement of plaque volume (3D) and intima-media thickness (IMT). Coronary artery calcification (CAC) was assessed using computed tomography (CT). Plaque volume in the right and left carotid arteries was averaged and patients were categorized by tertiles of increasing plaque volume. The prevalence and clinical correlates of carotid atherosclerosis were compared across groups. Discrimination for CAC detection using 3D carotid ultrasound versus IMT was also assessed with receiver operating curve (ROC) analysis.
Results Any carotid atherosclerosis was common, detectable in 70% of participants using 3D carotid ultrasound. Greater carotid atherosclerotic burden was associated with increasing age, lower high-density lipoprotein cholesterol, smoking, white race and male gender (p<0.05 for all comparisons). Carotid atherosclerosis was also strongly associated with CAC as the prevalence of CAC > 100 was 20.3%, 34.6%, 50.1% and 62.2% across groups (p<0.001). Discrimination for detection of CAC was also higher using 3D carotid ultrasound compared to IMT with c-statistics of 0.69 and 0.59 for CAC > 100; and 0.71 and 0.59 for CAC > 400, respectively (Figure).
Conclusion In this large observational study, carotid atherosclerosis as detected by 3D volumetric ultrasound is highly prevalent and associated with traditional risk factors. Compared to IMT, carotid atherosclerosis as visualized by 3D ultrasound is a better predictor of CAC, suggesting that this novel modality may be superior to IMT in detection of systemic vascular disease.
- © 2012 by American Heart Association, Inc.