Combined Femoral and Carotid Plaque Burden Identifies Obstructive Coronary Artery Disease in Women

Colledanchise, Kayla N.; Mantella, Laura E.; Bullen, M. A.; Hétu, Marie-France; Abunassar, Joseph; Johri, Amer M.

doi:10.1016/j.echo.2019.07.024

Cited by 27 publications

(15 citation statements)

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“…33 On the other hand, women did not present with a doseresponse association, but a critical increase in the probability of carotid plaque was observed once peripheral artery disease (symptomatic or asymptomatic) was present. This finding, also highlighted by Colledanchise et al, 34 may have particular value for cardiovascular risk assessment in women. Indeed, the Atherosclerosis Risk in Communities study showed that accounting for carotid plaque presence in addition to IMT leads to greater improvement of risk prediction in women than in men.…”

Section: Discussionsupporting

confidence: 65%

Polyvascular Subclinical Atherosclerosis: Correlation Between Ankle Brachial Index and Carotid Atherosclerosis in a Population-Based Sample

et al. 2022

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We assessed the correlation between the biomarkers of lower limb atherosclerosis (eg, ankle-brachial index [ABI]) and of carotid atherosclerosis (eg, common carotid intima-media thickness (IMT) and presence of atherosclerotic plaque) in a population-based cohort from Girona (Northwest Spain) recruited in 2010. Ankle-brachial index and carotid ultrasound were performed in all participants. Generalized additive multivariable models were used to adjust a regression model of common carotid IMT on ABI. Logistic regression multivariable models were adjusted to assess the probability of carotid plaque in individuals with peripheral artery disease. We included 3307 individuals (54.2% women), mean age 60 years (standard deviation 11). Two patterns of association were observed between subclinical biomarkers of atherosclerosis at the lower limb and carotid artery. Ankle-brachial index and common carotid IMT showed a linear trend in men [beta coefficient (95% confidence interval) =-.068 (−.123; −.012); P = .016]. Women with peripheral artery disease presented with high risk of atherosclerotic plaque at the carotid artery [Odds ratio (95% confidence interval) = 2.61, (1.46; 4.69); P = .001]. Men showed a significant linear association between ABI levels and common carotid IMT values. Women with peripheral artery disease presented with high risk of atherosclerotic plaque at the carotid artery.

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Section: Discussionsupporting

confidence: 65%

Polyvascular Subclinical Atherosclerosis: Correlation Between Ankle Brachial Index and Carotid Atherosclerosis in a Population-Based Sample

et al. 2022

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“…However, increased total cholesterol in formerly PE participants may simply stem from higher average BMI among these women. Carotid plaque area and height are effective surrogates of coronary artery stenosis (Colledanchise et al, 2019 ; Johri et al, 2016 ). However, carotid plaque deposition, an atherosclerotic endpoint, is uncommon in women of child‐bearing age.…”

Section: Discussionmentioning

confidence: 99%

Increased carotid artery stiffness after preeclampsia in a cross‐sectional study of postpartum women

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Hétu

et al. 2022

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Preeclampsia (PE) is a hypertensive obstetrical complication associated with increased cardiovascular disease risk. Carotid artery functional assessments allow for identification of subclinical vascular dysfunction. This cross-sectional study measured carotid artery functional indices in healthy women with a recent pregnancy complicated by PE, versus women with a prior uncomplicated pregnancy.Women with a history of PE (N = 30) or an uncomplicated pregnancy (N = 30), were recruited between 6 months and 5 years postpartum. Left and right carotid artery ultrasound measured carotid intima media thickness, plaque burden, peak systolic velocity, end diastolic flow velocity and carotid far-wall circumferential strain (FWCS). Carotid FWCS is inversely related to vessel stiffness, where a decrease in FWCS indicates increased vessel stiffness. Right-side FWCS did not differ between women with a history of PE versus normotensive pregnancy. Left carotid artery FWCS was lower in formerly preeclamptic women after adjustment for diameter, pulse pressure, and heart rate compared to women following an uncomplicated pregnancy (3.35 ± 1.08 × 10 −3 vs. 4.46 ± 1.40 × 10 −3 ; p = 0.003).Those with prior severe PE had the greatest decrease in FWCS adjusted to diameter, pulse pressure, and heart rate compared to healthy controls (p = 0.02).Adjusted FWCS and total serum cholesterol were independent indicators of PE history when present in a logistic regression model with confounding variables including age, body mass index, and resting blood pressure. Further investigation is needed to elucidate if FWCS can be used as a risk stratification tool for future cardiovascular disease following a pregnancy complicated by PE. A history of PE is associated with decreased left FWCS (increased left carotid artery stiffness). K E Y W O R D Scarotid arteries, postpartum period, preeclampsia, vascular stiffness HighlightsCarotid artery function was assessed after preeclampsia or uncomplicated pregnancy. Left carotid far-wall circumferential strain, which is inversely correlated with carotid stiffness, was lower after severe preeclampsia. Carotid artery stiffness after severe preeclampsia may inform future disease risk.

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“…Неинвазивная визуализация распространенного субклинического атеросклероза сонных и бедренных артерий с определением бремени атеросклероза представляет собой интегральный подход к оценке вероятности наличия коронарного атеросклероза и риска развития сердечно-сосудистых катастроф [12,13]. В настоящее время актуальной задачей является отбор наиболее информативных маркеров, поиск их пороговых значений и установление про-гностической значимости в проспективных исследованиях [14].…”

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Ultrasound Atherosclerosis Burden Score as a tool for predicting adverse cardiovascular events in patients with various cardiovascular risks aged 40-64 years

et al. 2022

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Aim. To investigate the prognostic significance of the Atherosclerosis Burden Score (ABS) in relation to the development of major adverse cardiovascular events in patients of different cardiovascular risks (CVR) aged 40 to 64 years.Material and methods. Men and women aged 40 to 64 years were included in the study. All the patients underwent duplex scanning of the carotid arteries and lower limb arteries. The total ABS was calculated by assessing the presence of plaque in the carotid and femoral bifurcations on both sides. The combined endpoint was cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, coronary revascularization, or peripheral artery revascularization.Results. The study included 232 patients who met the inclusion criteria, with a median age of 55,0 years. Very high CVR was established in 94 (40,5%) patients, while high CVR — in 48 (20,7%) patients, and low and intermediate CVR — in 90 (38,8%) patients. The follow-up period lasted 23,6 (15,5; 51,2) months, providing 632,6 patient-years of follow-up. Events within composite endpoint occurred in 28 (12,1%) patients. Increased cumulative risk of adverse cardiovascular events was observed for ABS ≥2, with a significant increase in relative risk (RR) for ABS ≥3. According to Cox regression analysis, ABS 3 was associated with a 3,71-fold (95% CI 1,18-11,6; p=0,025) increase in the RR of adverse cardiovascular events after adjustment for sex, age, baseline CVR, obesity, smoking, diabetes, CAD, a history of myocardial revascularization, type 2 diabetes, drug therapy, and levels of non-high density lipoprotein cholesterol, highly sensitive C-reactive protein, and glomerular filtration rate.Conclusion. In patients of various CVR aged 40-64 years, an ABS ≥3 was associated with a 3,71-fold (95% CI, 1,18-11,6; p=0,025) increase in relative risk of adverse cardiovascular events after adjusting for potential confounders, including sex, age, baseline CVR, CAD, and type 2 diabetes.

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Combined Femoral and Carotid Plaque Burden Identifies Obstructive Coronary Artery Disease in Women

Cited by 27 publications

References 36 publications

Polyvascular Subclinical Atherosclerosis: Correlation Between Ankle Brachial Index and Carotid Atherosclerosis in a Population-Based Sample

Polyvascular Subclinical Atherosclerosis: Correlation Between Ankle Brachial Index and Carotid Atherosclerosis in a Population-Based Sample

Increased carotid artery stiffness after preeclampsia in a cross‐sectional study of postpartum women

Ultrasound Atherosclerosis Burden Score as a tool for predicting adverse cardiovascular events in patients with various cardiovascular risks aged 40-64 years

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