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Published on: February 7, 2015

Acoustic shadowing on B-mode ultrasound of the carotid artery predicts CHD

K J Hunt1, A R Sharrett, L E Chambless

  • 1Department of Epidemiology, University of North Carolina, Chapel Hill, NC 27514, USA.

Ultrasound in Medicine & Biology
|May 23, 2001
PubMed

Insights

Carotid artery lesions (CALs) predict coronary heart disease (CHD) events. Mineralized CALs, indicated by acoustic shadowing (AS), showed a stronger association with CHD in women, highlighting their cardiovascular risk.

Area of Science:

  • Cardiovascular Medicine
  • Medical Imaging
  • Epidemiology

Background:

  • Carotid artery lesions (CALs) are indicators of atherosclerosis.
  • Acoustic shadowing (AS) on ultrasound suggests arterial mineralization, a marker of advanced plaque.
  • The link between mineralized CALs and incident coronary heart disease (CHD) requires further elucidation.

Purpose of the Study:

  • To investigate the association between carotid artery lesions (CALs), with and without acoustic shadowing (AS), and incident coronary heart disease (CHD).
  • To determine if arterial mineralization, indicated by AS, modifies the relationship between CALs and CHD risk.
  • To explore potential sex differences in the association between CALs, AS, and CHD.

Main Methods:

  • Utilized data from the Atherosclerosis Risk in Communities study cohort (12,375 participants, ages 45-64, CHD-free at baseline).
  • B-mode ultrasound identified CALs with and without AS in a 3-cm carotid bifurcation segment.
  • Cox proportional hazards models were used to assess incident CHD events over 1987-1995, adjusting for major CHD risk factors.

Main Results:

  • CALs were associated with increased risk of incident CHD events in both sexes after adjusting for risk factors.
  • For women, CALs without AS had a hazard ratio (HR) of 1.78 (95% CI: 1.22, 2.60) and CALs with AS had an HR of 1.73 (95% CI: 1.07, 2.80) compared to no CALs.
  • For men, the corresponding HRs were 1.59 (95% CI: 1.22, 2.07) for CALs without AS and 1.04 (95% CI: 0.72, 1.51) for CALs with AS compared to no CALs. The association was stronger for mineralized CALs in women.

Conclusions:

  • Carotid artery lesions (CALs) are significant predictors of incident coronary heart disease (CHD).
  • Arterial mineralization, indicated by acoustic shadowing (AS), strengthens the association between CALs and CHD risk, particularly in women.
  • These findings underscore the importance of assessing carotid artery calcification for cardiovascular risk stratification.

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