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Early atherosclerosis detection in asymptomatic patients: a comparison of carotid ultrasound, coronary artery calcium score, and coronary computed tomography angiography.
- Source :
-
The Canadian journal of cardiology [Can J Cardiol] 2013 Dec; Vol. 29 (12), pp. 1687-94. Date of Electronic Publication: 2013 Oct 05. - Publication Year :
- 2013
-
Abstract
- Background: Detailed multimodality assessment of subclinical atherosclerosis in asymptomatic subjects referred for risk stratification has not been performed. We analyzed the detection of early atherosclerosis using 3 imaging modalities: coronary artery calcium (CAC) scoring, carotid ultrasound (US), and coronary computed tomography angiography (CCTA).<br />Methods: Asymptomatic subjects free of known vascular disease scheduled to undergo a carotid US for risk stratification were invited to undergo CCTA/CAC. Subjects taking lipid-lowering medication were excluded. All images were assessed by experienced core laboratory personnel. Carotid intima media thickness ≥ 75th percentile for age and sex, CAC > 0, and detection of either carotid or coronary artery plaque were indicators of atherosclerosis.<br />Results: Fifty patients were included with a median age of 53 years. Atherosclerosis was observed in 28%, 78%, and 90% of subjects using CAC, CCTA, and carotid US, respectively. All subjects showed atherosclerosis on at least 1 modality. In 36 patients with a CAC score = 0, 69% and 86% had atherosclerosis on CCTA and carotid US, respectively.<br />Conclusions: In this detailed analysis, all subjects identified to warrant further risk stratification had subclinical atherosclerosis on at least 1 imaging modality. Concordance between modalities was highly variable, dependent on the specific definition of atherosclerosis used. Carotid US and CCTA detection of plaque were significantly more sensitive than CAC > 0 in this middle-aged population. Considering the prevalence of subclinical disease on carotid US and CCTA, the threshold at which to treat warrants further research.<br /> (Copyright © 2013 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Aged
British Columbia
Calcinosis classification
Carotid Stenosis classification
Coronary Artery Disease classification
Early Diagnosis
Female
Humans
Male
Middle Aged
Reference Values
Risk Assessment
Calcinosis diagnosis
Carotid Stenosis diagnosis
Coronary Angiography
Coronary Artery Disease diagnosis
Tomography, X-Ray Computed
Ultrasonography
Subjects
Details
- Language :
- English
- ISSN :
- 1916-7075
- Volume :
- 29
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- The Canadian journal of cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 24267808
- Full Text :
- https://doi.org/10.1016/j.cjca.2013.10.003