Publication: Progression of carotid plaque volume predicts cardiovascular events
Issued Date
2013-07-01
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ISSN
15244628
00392499
00392499
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2-s2.0-84879905973
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Mahidol University
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SCOPUS
Bibliographic Citation
Stroke. Vol.44, No.7 (2013), 1859-1865
Suggested Citation
Thapat Wannarong, Grace Parraga, Daniel Buchanan, Aaron Fenster, Andrew A. House, Daniel G. Hackam, J. David Spence Progression of carotid plaque volume predicts cardiovascular events. Stroke. Vol.44, No.7 (2013), 1859-1865. doi:10.1161/STROKEAHA.113.001461 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/32278
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Title
Progression of carotid plaque volume predicts cardiovascular events
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Abstract
BACKGROUND AND PURPOSE - : Carotid ultrasound evaluation of intima-media thickness (IMT) and plaque burden has been used for risk stratification and for evaluation of antiatherosclerotic therapies. Increasing evidence indicates that measuring plaque burden is superior to measuring IMT for both purposes. We compared progression/regression of IMT, total plaque area (TPA), and total plaque volume (TPV) as predictors of cardiovascular outcomes. METHODS - : IMT, TPA, and TPV were measured at baseline in 349 patients attending vascular prevention clinics; they had TPA of 40 to 600 mm at baseline to qualify for enrollment. Participants were followed up for ≤5 years (median, 3.17 years) to ascertain vascular death, myocardial infarction, stroke, and transient ischemic attacks. Follow-up measurements 1 year later were available in 323 cases for IMT and TPA, and in 306 for TPV. RESULTS - : Progression of TPV predicted stroke, death or TIA (Kaplan-Meier logrank P=0.001), stroke/death/MI (P=0.008) and Stroke/Death/TIA/Myocardial infarction (any Cardiovascular event) (P=0.001). Progression of TPA weakly predicted Stroke/Death/TIA (P=0.097) but not stroke/death/MI (P=0.59) or any CV event (P=0.143); likewise change in IMT did not predict Stroke/Death/MI (P=0.13) or any CV event (P=0.455 ). In Cox regression, TPV progression remained a significant predictor of events after adjustment for coronary risk factors (P=0.001) but change in TPA did not. IMT change predicted events in an inverse manner; regression of IMT predicted events (P=0.004). CONCLUSIONS - : For assessment of response to antiatherosclerotic therapy, measurement of TPV is superior to both IMT and TPA. © 2013 American Heart Association, Inc.