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Surrogate markers for atherosclerotic disease
Raaj R Sankatsing1, Eric de Groot, J Wouter Jukema
1Department of Vascular Medicine, Academic Medical Center, University of Amsterdam, The Netherlands.
Current Opinion in Lipidology
|July 2, 2005
Summary
Validated imaging markers for atherosclerosis are crucial for efficient cardiovascular prevention trials. Carotid intima-media thickness is a well-established predictor, while intravascular ultrasound and CT offer quantitative plaque assessment, with CMR showing future promise.
Area of Science:
- Cardiovascular Medicine
- Medical Imaging
- Preventive Cardiology
Background:
- Novel cardiovascular prevention treatments require validated surrogate markers for efficient drug development.
- Traditional clinical endpoints are time-consuming and costly for evaluating new therapeutic compounds.
- Imaging markers have become integral to drug-development strategies for atherosclerosis.
Purpose of the Study:
- To review commonly used imaging techniques as surrogate markers for atherosclerosis.
- To discuss the utility of these markers in cardiovascular prevention drug development.
- To highlight the strengths and limitations of various imaging modalities.
Main Methods:
- Review of established and emerging imaging techniques for atherosclerosis assessment.
- Discussion of flow-mediated dilation for endothelial function.
- Evaluation of carotid intima-media thickness, intravascular ultrasound, multidetector CT, electron-beam CT, and cardiovascular magnetic resonance (CMR).
Main Results:
- Flow-mediated dilation and carotid intima-media thickness predict cardiovascular events; intima-media thickness is widely used in intervention studies.
- Intravascular ultrasound allows reproducible assessment of coronary atheroma volume.
- CT techniques provide quantitative plaque burden and coronary calcium content; CMR requires further technical development for multicenter studies.
Conclusions:
- Imaging modalities offer insights into vascular function and morphology.
- Carotid intima-media thickness has the most extensive evidence for cardiovascular risk prediction.
- Intravascular ultrasound directly quantifies coronary changes, but predictive value needs establishment; CMR shows future potential for atherosclerosis evaluation.