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Measurement of atherosclerosis: development of an atherosclerosis severity index
1Department of Medicine, University of Western Ontario, London, Canada.
Insights
Researchers developed a new atherosclerosis severity index using clinical and ultrasound data. This noninvasive tool aids in efficiently measuring atherosclerosis progression for intervention studies, potentially replacing costly angiographic methods.
Area of Science:
- Cardiovascular Medicine
- Medical Technology Assessment
Background:
- Hypertension treatment effectively prevents pressure-related complications like heart failure and renal failure.
- Emerging evidence suggests antihypertensive drugs influence lipoproteins and flow disturbances, impacting atherosclerosis progression.
- Advances in hyperlipidemia treatment necessitate studies evaluating anti-atherosclerotic interventions.
Purpose of the Study:
- To develop efficient methods for measuring atherosclerosis to facilitate intervention studies.
- To create a novel atherosclerosis severity index as a surrogate outcome measure.
- To avoid resource-intensive and risky angiographic assessments in clinical trials.
Main Methods:
- Development of an atherosclerosis severity index.
- Utilizing clinical assessments and noninvasive ultrasound measurements.
- Establishing a tool suitable for repeated assessments over time.
Main Results:
- A novel atherosclerosis severity index has been developed.
- The index integrates clinical and noninvasive ultrasound data.
- The method is suitable for repeated measurements, enabling advanced statistical analyses.
Conclusions:
- The developed atherosclerosis severity index offers a cost-effective and less invasive alternative to angiography.
- This index can serve as a surrogate outcome, improving the efficiency of anti-atherosclerotic intervention studies.
- The tool's suitability for repeated assessments enhances its utility for longitudinal outcome analysis.
Abstract:
Treatment of hypertension has succeeded in preventing the complications attributable to pressure, including heart failure and the arteriolar complications such as brain hemorrhage and renal failure. Recent understanding that antihypertensive drugs have effects on lipoproteins and flow disturbances that may be important in atherosclerosis progression, and the recent development of drugs that are more effective in treating hyperlipidemia, have given impetus to the design of studies to test whether interventions are anti-atherosclerotic. Since studies depending on clinical endpoints by necessity consume vast resources, it is desirable to develop methods for measurement of atherosclerosis, in order to make it possible to conduct intervention studies efficiently. Because angiographic methods are costly and associated with risk, and many patients are unable or unwilling to undergo followup angiography at the end of a study, we are developing an atherosclerosis severity index based on clinical and noninvasive ultrasound assessment. This scale can be used as a surrogate outcome in place of, or complementary to angiographic measurement of atherosclerosis, to avoid costly loss of subjects in intervention studies. It has the additional advantage that it is suitable for repeated assessment over time, permitting the power of analyses such as life table analysis which look at time to development of endpoints.