Impact of Image Interpretation of Carotid Ultrasound Findings on Lipid Management in Patients With Elevated ASCVD
Xiaochuan Liu1, Sichen Yao2, Hua Yang1
1Department of General Practice, Zhongshan Hospital, Fudan University, Shanghai, China.
Insights
General practitioners interpreting carotid ultrasound findings improved lipid management in elderly patients at high risk for atherosclerotic cardiovascular disease (ASCVD). This intervention led to a significant reduction in low-density lipoprotein (LDL) levels.
Area of Science:
- Cardiology
- Vascular Medicine
- General Practice
Background:
- General practitioners (GPs) play a crucial role in managing patients with atherosclerotic cardiovascular disease (ASCVD) risk factors.
- Lipid management is a cornerstone of ASCVD prevention.
- The impact of integrating advanced diagnostic interpretation into primary care requires further investigation.
Purpose of the Study:
- To evaluate the effect of carotid ultrasound finding interpretation by GPs on lipid management in elderly patients.
- To compare lipid profile changes in patients receiving routine care versus those with GP-interpreted carotid ultrasound results.
Main Methods:
- An observational cohort study involving 338 elderly patients (≥60 years) at elevated ASCVD risk.
- Participants were divided into an image interpretation group and a routine care group, followed for 3 months.
- Primary outcome: change in low-density lipoprotein (LDL) levels; Secondary outcomes: changes in total cholesterol (TC), triglyceride (TG), and high-density lipoprotein (HDL).
Main Results:
- The image interpretation group showed a statistically significant greater reduction in LDL levels compared to the routine care group (β = -0.38, p=0.028).
- This significant LDL reduction persisted after adjusting for confounders (β = -0.38, p=0.025).
- No significant between-group differences were observed for changes in TC, HDL, or TG.
Conclusions:
- Interpreting carotid ultrasound findings by GPs significantly enhances lipid management in elderly patients with elevated ASCVD risk.
- This approach offers a valuable strategy for improving cardiovascular risk factor control in primary care settings.
- Routine care combined with image interpretation of carotid ultrasound results demonstrates a positive impact on LDL reduction.
Background:
This study aimed to explore the impact of carotid ultrasound finding interpretation by general practitioners (GPs) on patients' lipid management.
Methods:
This study is an observational cohort study involving elderly patients aged ≥ 60 years with elevated risk of atherosclerotic cardiovascular disease (ASCVD). Participants were divided into two groups: image interpretation group and routine care group, and then followed for 3 months. Our primary outcome was to explore the between-group differences in low-density lipoprotein (LDL) changes between the two groups at baseline and after 3 months of follow-up. Secondary outcomes included between-group differences in changes of total cholesterol (TC), triglyceride (TG), and high-density lipoprotein (HDL). The Generalized Estimating Equation model was used to calculate interaction p values, β coefficients, and their 95% CIs.
Results:
This study enrolled 338 participants, with 169 in the image interpretation group (age 69.6 ± 5.76 years) and 169 in the routine care group (age 71.59 ± 5.26 years). The between-group difference in LDL change from baseline to follow-up was statistically significant (interaction p = 0.028), with a β coefficient of -0.38 (95% CI -0.71, -0.04), indicating that the image interpretation group had a 0.38 mmol/L greater LDL reduction than the routine care group. This remained significant after adjusting for confounders (interaction p = 0.025, β = -0.38, 95% CI -0.70, -0.05). There were no significant between-group differences observed against changes in TC, HDL, and TG.
Conclusion:
This study indicated that adding image interpretation of carotid ultrasound results to routine care by GPs significantly improves lipid management in elderly patients with elevated ASCVD risk.
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