Carotid Ultrasound May Identify Cardiac Risk

Changes detected on carotid ultrasound may identify patients at high risk for major adverse cardiovascular events

WEDNESDAY, Aug. 20 (HealthDay News) -- Carotid artery lesions identified by ultrasound and demonstrating increasing echolucency may indicate increased risk for major adverse cardiovascular events, and repeat testing may identify patients at particularly high risk for near-future events, according to an article published in the September issue of Radiology.

Markus Reiter, M.D., of the Medical University Vienna in Austria, and colleagues prospectively examined 574 patients with carotid plaques of at least 30 percent to determine whether decreasing gray-scale median (GSM) levels at repeat carotid ultrasound examinations are associated with future risk of major adverse cardiovascular events. Ultrasounds were obtained at baseline and at follow-up between six and nine months, and patients were then followed-up clinically for major adverse cardiovascular events (median 3.2 years).

The investigators found the median change in carotid GSM was 2.9 with 40 percent of patients experiencing a decline and 60 percent experiencing an increase. Major adverse cardiovascular events occurred in 31 percent of patients, the report indicates. Compared to the highest quartile of GSM change, adjusted hazard ratios were 1.71 for the lowest quartile, 1.36 for the second quartile and 1.22 for the third quartile, the researchers report.

"In conclusion, patients with increasing plaque echolucency quantified by decreasing GSM levels of carotid plaques are at high risk for midterm adverse events of atherosclerosis affecting the coronary, peripheral and cerebrovascular circulation, irrespective of the individual's cardiovascular risk profile and prevalent atherosclerotic comorbidities," the authors write. "GSM testing of the carotid arteries in six- to nine-month intervals may help identify patients who have a particularly high cardiovascular risk."

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