Carotid plaque-thickness and common carotid IMT show additive value in cardiovascular risk prediction and reclassification
Risk prediction for cardiovascular disease (CVD) remains suboptimal even after the introduction of global risk assessment by various scores. This has prompted the search for additional biomarkers such as cIMTmax (an index of the thickest plaque detected in the whole carotid tree) and PF CC-IMTmean (an index of the common carotid background thickening measured in plaque free areas). Taken by themselves, both the variables have been associated with the incidence of cardiovascular disease, but their complementarity in cardiovascular risk prediction/reclassification is still under debate. In our study, both variables were mutually independent predictors of cerebral and coronary vascular events. In reclassification analyses, PF CC-IMTmean adds to a model including Framingham Risk Factors and cIMTmax and vice-versa. We conclude that cIMTmax and PF CC-IMTmean should be used as additive rather than alternative variables in risk prediction/reclassification and that a risk stratification strategy based on the concomitant measurement of cIMTmax and PF CC-IMTmean as an adjunct to vascular risk factors is a rational approach for better identifying subjects who need to be treated with pharmacological and/or lifestyle intervention (diet, smoking cessation etc.).
Atherosclerosis. 2017 May 19. pii: S0021-9150(17)30226-5.
doi: 10.1016/j.atherosclerosis.2017.05.023. [Epub ahead of print]
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