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Comparing Carotid Artery Velocities with Current ASCVD Risk Stratification: A Novel Approach to Simpler Risk
Yueh-Chien Lu1,2, Po-Ju Chen1,2, Sheng-Nan Lu3,4
1Department of Occupational Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
Journal of Epidemiology and Global Health
|September 30, 2024
Summary
Carotid artery blood flow velocities, specifically end diastolic velocity (EDV) and peak systolic velocity (PSV), show nonlinear associations with atherosclerotic cardiovascular disease (ASCVD) risk. Identifying optimal velocity ranges may enhance ASCVD risk assessment.
Area of Science:
- Cardiovascular Medicine
- Medical Imaging
- Biophysics
Background:
- Atherosclerotic cardiovascular disease (ASCVD) risk stratification is crucial for primary prevention.
- Current methods rely on traditional risk factors, but novel approaches are needed for enhanced accuracy.
- Carotid artery hemodynamics offer a potential non-invasive marker for cardiovascular risk.
Purpose of the Study:
- To investigate the relationship between carotid artery flow velocities and ASCVD risk.
- To compare a novel hemodynamic approach with existing ASCVD risk stratification methods.
- To identify optimal velocity thresholds for predicting cardiovascular events.
Main Methods:
- Prospective study of 1636 participants aged 40-75 without prior ASCVD.
- Carotid flow velocities measured using duplex ultrasonography.
- ASCVD risk categorized using 2022 USPSTF guidelines; associations analyzed via logistic regression and generalized additive models (GAMs).
Main Results:
- End diastolic velocity (EDV) of common carotid artery (CCA) and peak systolic velocity (PSV) of internal carotid artery (ICA) showed inverse, nonlinear associations with ASCVD risk.
- Optimal velocity ranges identified: CCA EDV ~23.75 cm/s, ICA PSV ~81.75 cm/s, ICA EDV ~26.75 cm/s.
- GAMs revealed U-shaped relationships between elevated ASCVD risk and carotid flow velocities, with similar inflection points.
Conclusions:
- Carotid artery EDVs and PSVs are linked to cardiovascular event development.
- Specific optimal velocity ranges were determined for CCA and ICA.
- Further hemodynamic research is necessary to validate these findings for clinical application.
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