Abstract 13890: Rate of Carotid Disease Progression in Asymptomatic Low to Moderate Risk Individuals: The Right Study
Introduction: Cardiovascular disease is a leading cause of death in industrialized countries. Advances in imaging enable serial assessment of atherosclerosis and could provide insights into disease progression. The aim of this study was to examine the feasibility of serial carotid MRI in a low to moderate risk population and to analyze the association between the progression of carotid MRI findings and clinical factors.
Methods: High resolution 3T carotid MRI was performed on 88 asymptomatic subjects with hyperlipidemia at baseline and after 1 year follow up as part of the RIGHT study (‘Randomized Trial of Imaging Versus Risk Factor-Based Therapy for Plaque Regression’). All subjects received statin therapy. Wall volume (WV), remodeling index (RI calculated as percentage WV of outer vessel volume) and wall thickness (WT) was measured in 5 axial slices of the proximal internal carotid artery. Comparable slices in the follow up exam were selected. The relationship of parameters of progression with risk factors was evaluated using multivariable analysis.
Results: The mean subject age was 64 years (65 % male). The mean Framingham 10 year risk for CAD was 9% and the mean AHA 10 year risk was 11.7%. In a multivariate model (including age, gender, hypertension, systolic and diastolic blood pressure, BMI, diabetes, creatinine and LDL) the only parameters associated with disease progression were the diagnosis of arterial hypertension and creatinine. After calculation of the GFR (MDRD) the association with renal function parameters was no longer present and hypertension remained as the only parameter that was significantly associated with carotid disease progression (standardized β=0.294, p=0.008 for average RI and standardized β=0.233, p=0.035 for average WT).
Conclusions: Hypertension is associated with progression of carotid atherosclerosis in this statin treated study sample. An association with creatinine but not GFR was noted. There was no correlation with other clinical factors (age, gender, BMI, LDL, diabetes and GFR). This finding could reflect different drivers of atherosclerosis over the time course of the disease. Serial imaging can advance the understanding of cardiovascular disease and help improve patient treatment in the future.
Author Disclosures: V. Sandfort: None. C.T. Sibley: None. E. Turkbey: None. M. Ahlman: None. A. Zavodni: None. M. Mallek: None. S. Liu: None. J. Vargas: None. D.A. Bluemke: None.
- © 2014 by American Heart Association, Inc.