Determinants of Carotid Plaque Occurrence

Prati, Patrizio; Vanuzzo, Diego; Casaroli, M.; Bader, Giovanni; Mos, Lucio; Pilotto, Lorenza; Canciani, Luigi; Ruscio, Maurizio; Touboul, Pierre‐Jean

doi:10.1159/000094993

Cited by 43 publications

(16 citation statements)

References 52 publications

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“…Several studies conducted in predominantly Caucasian populations reported cross-sectional associations between cIMT and plaque [31-33]. In addition, five longitudinal studies, with time spans from four to twelve years, have shown positive associations between cIMT, particularly in the CCA, with the development of carotid plaque [24, 30, 34-36]. Our findings regarding CCA cIMT in relation to incident plaque are not inconsistent with the latter studies.…”

Section: Discussionsupporting

confidence: 59%

“…Our findings regarding CCA cIMT in relation to incident plaque are not inconsistent with the latter studies. However, differences in study design, including longer follow up in other studies [34, 35], categorization of cIMT [24, 30, 34] rather than a continuous examination, as well as differences in study sample characteristics and size may explain variability in findings. The other longitudinal studies did not examine lateral-specific ICA and bif cIMT in relation to incident plaque like we did.…”

Section: Discussionmentioning

confidence: 99%

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The relationship between carotid intima-media thickness and carotid plaque in the Northern Manhattan Study

et al. 2015

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Objective Carotid intima–media thickness (cIMT) and carotid plaque (CP) are proposed biomarkers of subclinical atherosclerosis associated with stroke risk. Whether cIMT and CP are distinct phenotypes or single traits at different stages of atherosclerotic development is unclear. We explored the relationship between these markers in the population-based Northern Manhattan Study. Methods We used high-resolution ultrasound and validated imaging protocols to study the cross-sectional (N=1,788 stroke-free participants) and prospective relationship (N=768 with follow-up scan; mean years between examinations=3.5) between CP and cIMT measured in plaque-free areas. Results The mean age was 66±9 (40% male, 19% black, 17% white, 61% Hispanic). The mean baseline cIMT was 0.92±0.09mm, 0.94±0.09mm among the 58% with prevalent plaque, 0.90±0.08mm among the 42% without prevalent plaque (p<0.0001). Each 0.1mm increase in baseline cIMT was associated with a 1.72-fold increased odds of plaque presence (95%CI=1.50-1.97), increased plaque thickness (effect on the median=0.46mm, p<0.0001), and increased plaque area (effect on the median=3.45mm2, p<0.0001), adjusting for demographics and vascular risk factors. Elevated baseline cIMT was associated with an increased risk of new plaque in any location at follow-up, but after adjusting for demographics and vascular risk factors this association was no longer present. No association was observed in carotid segment-specific analyses. Conclusion Increased cIMT was associated with baseline prevalent plaque but did not predict incident plaque independent of other vascular risk factors. This finding suggests that increased cIMT is not an independent predictor of plaque development although these atherosclerotic phenotypes often coexist and share some common vascular determinants.

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Section: Discussionsupporting

confidence: 59%

Section: Discussionmentioning

confidence: 99%

The relationship between carotid intima-media thickness and carotid plaque in the Northern Manhattan Study

et al. 2015

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“…Gnasso et al [50] showed that CIMT was strongly and significantly associated with the presence of plaques and/or stenosis in the carotid arteries after adjustment for coronary heart disease risk factors. The Aging Vascular Study [51], the Tromsø Study [52], the San Daniele Project [53] and a study of health in Pomerania [54] also confirmed that CIMT independently predicts incident carotid plaque formation in a prospective manner.…”

Section: Discussionmentioning

confidence: 91%

Low-grade albuminuria is associated with early but not late carotid atherosclerotic lesions in community-based patients with type 2 diabetes

Li¹,

Tu²,

Lu³

et al. 2013

Cardiovasc Diabetol

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BackgroundLow-grade albuminuria is associated with cardiovascular risk factors and mortality. Our aim was to investigate the association between low-grade albuminuria and carotid atherosclerotic lesions in community-based patients with type 2 diabetes.MethodsA cross-sectional study was performed in 475 community-based patients with type 2 diabetes (190 males and 285 females) with normal urinary albumin-to-creatinine ratios (UACR) (< 3.5 mg/mmol) from Shanghai, China. The subjects were stratified into tertiles based on UACR levels (the lowest tertile was UACR ≤ 1.19 mg/mmol, and the highest tertile was UACR ≥ 2 mg/mmol). Carotid intima-media thickness (CIMT), carotid atherosclerotic plaque formation and stenosis were assessed and compared among the three groups based on ultrasonography. The urinary albumin excretion rate was determined as the mean of the values obtained from three separate early morning urine samples.ResultsCompared with the subjects with UACR in the lowest tertile, the subjects with UACR in the middle and highest tertiles had greater CIMT values (0.88 ± 0.35 mm, 0.99 ± 0.43 mm and 1.04 ± 0.35 mm, respectively; all p < 0.05) and a higher prevalence of carotid atherosclerotic plaques (25.3%, 39.0% and 46.2%, respectively; all p < 0.05) after adjusting for sex and age. Fully adjusted multiple linear regression and logistic regression analyses revealed that UACR tertiles were significantly associated with elevated CIMT (p = 0.007) and that, compared with the subjects in the first tertile of UACR, those in the second and third tertiles had 1.878- and 2.028-fold risk of carotid plaques, respectively. However, there was no statistical association between UACR tertile and the prevalence of carotid stenosis.ConclusionsHigher UACR within the normal range was independently associated with early but not late carotid atherosclerotic lesions in community-based patients with type 2 diabetes. Low-grade albuminuria contributes to the risk of carotid atherosclerosis and may be used as an early marker for the detection of atherosclerosis in patients with type 2 diabetes.

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“…Several studies have suggested that an increased intima media thickness of the common carotid artery is a good predictor of atherosclerotic plaques occurrence [5,6,7]. In turn, the presence of carotid plaques is a powerful indicator of future ischemic events [8,9].…”

Section: Introductionmentioning

confidence: 99%

Carotid Plaque Morphology Improves Stroke Risk Prediction: Usefulness of a New Ultrasonographic Score

Prati¹,

Tosetto

Casaroli³

et al. 2011

Cerebrovasc Dis

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Carotid thickening and plaque detected by B-mode imaging ultrasound are useful to improve the ischemic risk evaluation in asymptomatic subjects over and beyond the traditional cardiovascular risk factors. Some plaque’s echographic parameters help describing the vascular risk. We hypothesized that the stenosis degree, plaque surface irregularity, echolucency and texture, compounded in a Total Plaque Risk Score (TPRS), are predictors of the ischemic events in the San Daniele study, a general population-based study of 1,348 subjects followed for 12 years in average. In the 171 subjects with at least one plaque at baseline, high TPRS was the most powerful independent predictor of cerebrovascular events, which occurred in 115 subjects. Addition of plaque characteristics significantly increased the area under the ROC curve (0.90 vs. 0.88, p = 0.04) versus the Framingham risk score alone. The TPRS is a potential new tool to improve the stroke risk prediction.

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Determinants of Carotid Plaque Occurrence

Cited by 43 publications

References 52 publications

The relationship between carotid intima-media thickness and carotid plaque in the Northern Manhattan Study

The relationship between carotid intima-media thickness and carotid plaque in the Northern Manhattan Study

Low-grade albuminuria is associated with early but not late carotid atherosclerotic lesions in community-based patients with type 2 diabetes

Carotid Plaque Morphology Improves Stroke Risk Prediction: Usefulness of a New Ultrasonographic Score

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