Carotid intima-media thickness and coronary artery calcium score as indications of subclinical atherosclerosis

Steven Jay Lester, Mackram Eleid, Bijoy K. Khandheria, R. Todd Hurst

Research output: Contribution to journalArticle

78 Citations (Scopus)

Abstract

OBJECTIVE: To determine the ability of carotid intima-media thickness (CIMT) and coronary artery calcium score (CACS) to detect subclinical atherosclerosis in a young to middle-aged, low-risk, primary-prevention population. PATIENTS AND METHODS: Patients aged 36 to 59 years who underwent determination of CIMT and CACS at our institution between May 1, 2004, and April 1, 2008, were included in the study. Those with diabetes mellitus or a history of coronary, peripheral, or cerebral vascular disease were excluded. Other information, such as Framingham risk score (FRS), was obtained by a review of clinical and laboratory data. RESULTS: Of 118 patients, 89 (75%) had a CACS of zero and 94 (80%) were men; mean ± SD age was 48.9±5.7 years. The mean FRS of this group was 4.0; 86 patients (97%) were considered at low risk (<1% annualized rate) of cardiovascular events. Evidence of carotid atherosclerosis was found in 42 (47%; 95% confidence interval, 37%-58%) of these 89 patients; carotid plaque was found in 30 (34%); and CIMT above the 75th percentile was found in 12 (13%) of age-, sex-, and race-matched control patients. Of the 40 patients with low-risk CIMT (below the 50th percentile), 4 (10%) had a CACS at or above the 50th percentile. CONCLUSION: Subclinical vascular disease can be detected by CIMT evaluation in young to middle-aged patients with a low FRS and a CACS of zero. These findings have important implications for vascular disease screening and the implementation of primary-prevention strategies.

Original languageEnglish (US)
Pages (from-to)229-233
Number of pages5
JournalMayo Clinic Proceedings
Volume84
Issue number3
DOIs
StatePublished - 2009

Fingerprint

Carotid Intima-Media Thickness
Atherosclerosis
Coronary Vessels
Calcium
Vascular Diseases
Primary Prevention
Carotid Artery Diseases
Diabetes Mellitus
Confidence Intervals
Population

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Carotid intima-media thickness and coronary artery calcium score as indications of subclinical atherosclerosis. / Lester, Steven Jay; Eleid, Mackram; Khandheria, Bijoy K.; Hurst, R. Todd.

In: Mayo Clinic Proceedings, Vol. 84, No. 3, 2009, p. 229-233.

Research output: Contribution to journalArticle

@article{5d84d54364794f97a1b3d977fce04b33,
title = "Carotid intima-media thickness and coronary artery calcium score as indications of subclinical atherosclerosis",
abstract = "OBJECTIVE: To determine the ability of carotid intima-media thickness (CIMT) and coronary artery calcium score (CACS) to detect subclinical atherosclerosis in a young to middle-aged, low-risk, primary-prevention population. PATIENTS AND METHODS: Patients aged 36 to 59 years who underwent determination of CIMT and CACS at our institution between May 1, 2004, and April 1, 2008, were included in the study. Those with diabetes mellitus or a history of coronary, peripheral, or cerebral vascular disease were excluded. Other information, such as Framingham risk score (FRS), was obtained by a review of clinical and laboratory data. RESULTS: Of 118 patients, 89 (75{\%}) had a CACS of zero and 94 (80{\%}) were men; mean ± SD age was 48.9±5.7 years. The mean FRS of this group was 4.0; 86 patients (97{\%}) were considered at low risk (<1{\%} annualized rate) of cardiovascular events. Evidence of carotid atherosclerosis was found in 42 (47{\%}; 95{\%} confidence interval, 37{\%}-58{\%}) of these 89 patients; carotid plaque was found in 30 (34{\%}); and CIMT above the 75th percentile was found in 12 (13{\%}) of age-, sex-, and race-matched control patients. Of the 40 patients with low-risk CIMT (below the 50th percentile), 4 (10{\%}) had a CACS at or above the 50th percentile. CONCLUSION: Subclinical vascular disease can be detected by CIMT evaluation in young to middle-aged patients with a low FRS and a CACS of zero. These findings have important implications for vascular disease screening and the implementation of primary-prevention strategies.",
author = "Lester, {Steven Jay} and Mackram Eleid and Khandheria, {Bijoy K.} and Hurst, {R. Todd}",
year = "2009",
doi = "10.4065/84.3.229",
language = "English (US)",
volume = "84",
pages = "229--233",
journal = "Mayo Clinic Proceedings",
issn = "0025-6196",
publisher = "Elsevier Science",
number = "3",

}

TY - JOUR

T1 - Carotid intima-media thickness and coronary artery calcium score as indications of subclinical atherosclerosis

AU - Lester, Steven Jay

AU - Eleid, Mackram

AU - Khandheria, Bijoy K.

AU - Hurst, R. Todd

PY - 2009

Y1 - 2009

N2 - OBJECTIVE: To determine the ability of carotid intima-media thickness (CIMT) and coronary artery calcium score (CACS) to detect subclinical atherosclerosis in a young to middle-aged, low-risk, primary-prevention population. PATIENTS AND METHODS: Patients aged 36 to 59 years who underwent determination of CIMT and CACS at our institution between May 1, 2004, and April 1, 2008, were included in the study. Those with diabetes mellitus or a history of coronary, peripheral, or cerebral vascular disease were excluded. Other information, such as Framingham risk score (FRS), was obtained by a review of clinical and laboratory data. RESULTS: Of 118 patients, 89 (75%) had a CACS of zero and 94 (80%) were men; mean ± SD age was 48.9±5.7 years. The mean FRS of this group was 4.0; 86 patients (97%) were considered at low risk (<1% annualized rate) of cardiovascular events. Evidence of carotid atherosclerosis was found in 42 (47%; 95% confidence interval, 37%-58%) of these 89 patients; carotid plaque was found in 30 (34%); and CIMT above the 75th percentile was found in 12 (13%) of age-, sex-, and race-matched control patients. Of the 40 patients with low-risk CIMT (below the 50th percentile), 4 (10%) had a CACS at or above the 50th percentile. CONCLUSION: Subclinical vascular disease can be detected by CIMT evaluation in young to middle-aged patients with a low FRS and a CACS of zero. These findings have important implications for vascular disease screening and the implementation of primary-prevention strategies.

AB - OBJECTIVE: To determine the ability of carotid intima-media thickness (CIMT) and coronary artery calcium score (CACS) to detect subclinical atherosclerosis in a young to middle-aged, low-risk, primary-prevention population. PATIENTS AND METHODS: Patients aged 36 to 59 years who underwent determination of CIMT and CACS at our institution between May 1, 2004, and April 1, 2008, were included in the study. Those with diabetes mellitus or a history of coronary, peripheral, or cerebral vascular disease were excluded. Other information, such as Framingham risk score (FRS), was obtained by a review of clinical and laboratory data. RESULTS: Of 118 patients, 89 (75%) had a CACS of zero and 94 (80%) were men; mean ± SD age was 48.9±5.7 years. The mean FRS of this group was 4.0; 86 patients (97%) were considered at low risk (<1% annualized rate) of cardiovascular events. Evidence of carotid atherosclerosis was found in 42 (47%; 95% confidence interval, 37%-58%) of these 89 patients; carotid plaque was found in 30 (34%); and CIMT above the 75th percentile was found in 12 (13%) of age-, sex-, and race-matched control patients. Of the 40 patients with low-risk CIMT (below the 50th percentile), 4 (10%) had a CACS at or above the 50th percentile. CONCLUSION: Subclinical vascular disease can be detected by CIMT evaluation in young to middle-aged patients with a low FRS and a CACS of zero. These findings have important implications for vascular disease screening and the implementation of primary-prevention strategies.

UR - http://www.scopus.com/inward/record.url?scp=62749198153&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=62749198153&partnerID=8YFLogxK

U2 - 10.4065/84.3.229

DO - 10.4065/84.3.229

M3 - Article

C2 - 19252109

AN - SCOPUS:62749198153

VL - 84

SP - 229

EP - 233

JO - Mayo Clinic Proceedings

JF - Mayo Clinic Proceedings

SN - 0025-6196

IS - 3

ER -