Arterial ultrasound screening as a tool for coronary risk assessment in asymptomatic men and women

Area of Science:

• Cardiovascular Medicine
• Medical Imaging
• Diagnostic Ultrasonography

Background:

• Cardiovascular diseases (CVDs) pose a significant global health burden.
• Doppler ultrasonography of carotid and femoral arteries is a common diagnostic tool for CVD.
• Early detection of subclinical atherosclerosis is crucial for CVD risk stratification.

Purpose of the Study:

• To evaluate the prognostic value of carotid and femoral artery abnormalities detected by Doppler ultrasonography in asymptomatic individuals.
• To determine the association between increased intima-media thickness (IMT) and arterial plaque with incident coronary events.

Main Methods:

• A cohort of 2709 participants without prior CVD symptoms underwent risk factor assessment and baseline carotid/femoral ultrasonography.
• Participants were followed for a median of 6 years for incident coronary events.
• Abnormalities included carotid stenosis >50%, carotid plaque, femoral plaque, and increased IMT (>0.63 mm).

Main Results:

• Approximately 63% of participants exhibited at least one arterial abnormality.
• Moderately increased IMT or the presence of carotid/femoral plaque was significantly associated with prognosis.
• The risk of coronary events increased substantially with the number of detected abnormalities, with hazard ratios ranging from 2.35 to 14.83.

Conclusions:

• Doppler ultrasonography of the carotid and femoral arteries is effective in identifying individuals at higher risk for future coronary events.
• Arterial abnormalities, including increased IMT and plaque, are significant independent predictors of cardiovascular prognosis in asymptomatic populations.
• The cumulative burden of multiple ultrasonographic abnormalities strongly correlates with increased event rates, aiding in risk stratification.