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Methodological issues facing studies of atherosclerotic change
J L Probstfield1, R P Byington, D A Egan
1Clinical Trials Branch, National Heart, Lung, and Blood Institute, Bethesda, MD 20892.
Circulation
|March 1, 1993
Summary
B-mode ultrasonography offers a cost-effective method for evaluating atherosclerosis progression. Further research is needed to refine its use in assessing intimal-medial thickness and clinical events.
Area of Science:
- Cardiovascular Medicine
- Medical Imaging
- Biomedical Engineering
Background:
- Coronary heart disease is linked to coronary artery lesions, prompting research into interventions for atherosclerotic change.
- B-mode ultrasound of peripheral arteries is currently the most accurate method for evaluating atherosclerotic disease extent.
Purpose of the Study:
- To strengthen the rationale for using B-mode ultrasonography in assessing atherosclerosis natural history.
- To address key methodological issues for improved clinical application.
Main Methods:
- Evaluating primary endpoints using composite/individual measurements of carotid artery atherosclerosis.
- Assessing new methodologies for lesion anatomy and rupture potential.
- Developing complementary methods using angiography and ultrasound wall assessment.
Main Results:
- Consistent methodology is crucial for valid, precise, and reliable measurements of atherosclerotic change.
- Multiple measurements and data reduction techniques can enhance comparisons.
- Identifying covariates and confounding interventions requires monitoring biochemical, physiological, and clinical variables.
Conclusions:
- B-mode ultrasonography offers cost/benefit advantages for continuous variable assessment (intimal-medial thickness).
- Demonstrating a direct link between intimal-medial thickness and clinical events is essential.
- Methodology for ultrasound assessment of atherosclerosis continues to evolve.