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Background: There is great need for a simple, noninvasive tool that can be used in an office setting to screen for subclinical atherosclerosis. In patients referred for cardiovascular(CV)risk assessment, we evaluated the ability of ultrasound screening for carotid plaque to identify patients with advanced subclinical atherosclerosis. Methods: Consecutive asymptomatic patients without vascular disease referred by their physician for measurement of the ankle-brachial pressur e index and carotid intima-media thickness(CIMT)were included. Carotid intima- media thickness was measured using the standardized ultrasound protocol from the Atherosclerosis Risk in Communities(ARIC)study. Advanced atherosclerosis was de fined as CIMT ≥75th percentile for age, sex, and race in ARIC.Results: The mean age of the 327 subjects was 55.4 years(SD 7.7 years). The 10-year Framingham C V risk was 5.1%(4.8%). In a multiple logistic regression model that included F ramingham CV risk, ankle-brachial pressure index, and use of lipid-lowering me dications, plaque presence significantly predicted advanced atherosclerosis(odds ratio 3.08, 95%CI 1.91-4.96, P< .001). In stepwise regression models that inc luded age, body mass index, current tobacco use, family history of premature CV disease, fasting glucose, sex, systolic blood pressure, total/high-density lipo protein cholesterol ratio, and use of antihypertensive and lipid-lowering medic ations, plaque presence independently predicted advanced atherosclerosis(P< .001 ). Conclusion: Ultrasound detection of carotid plaque helped identify asymptomat ic patients with advanced subclinical atherosclerosis. Screening for carotid pla que is easier than determination of CIMT and may help detect asymptomatic patien ts at increased CV risk.
Background: There is great need for a simple, noninvasive tool that can be used in an office setting to screen for subclinical atherosclerosis. In patients referred for cardiovascular (CV) risk assessment, we evaluated the ability of ultrasound screening for carotid plaque to identify patients with advanced subclinical atherosclerosis. Methods: Consecutive asymptomatic patients without vascular disease referred by their physician for measurement of the ankle-brachial pressur e index and carotid intima-media thickness (CIMT) were included. Carotid intima-media thickness was measured using the standardized ultrasound protocol from the Atherosclerosis Risk in Communities (ARIC) study. Advanced atherosclerosis was fined as CIMT ≥ 75th percentile for age, sex, and race in ARIC. Results: The mean age of the 327 subjects was 55.4 years (SD 7.7 years). The 10-year Framingham CV risk was 5.1% (4.8%). In a multiple logistic regression model that included Fmingham CV risk, ankle-brachial pressure index, and use of lipid-lowering me dications, plaque presence significantly predicted advanced atherosclerosis (odds ratio 3.08, 95% CI 1.91-4.96, P <.001) .In stepwise regression models that inc luded age, body mass index, current tobacco use, family history of premature CV disease, fasting glucose, sex, systolic blood pressure, total / high-density lipo protein cholesterol ratio, and use of antihypertensive and lipid- lowering medications, plaque presence independently predicted advanced atherosclerosis (P <.001 Conclusion: Ultrasound detection of carotid plaque helped identify asymptomat ic patients with advanced subclinical atherosclerosis. Screening for carotid pla que is easier than determination of CIMT and may help detect asymptomatic patien ts at increased CV risk.