Role of femoral artery ultrasound imaging in cardiovascular event risk prediction in a primary prevention cohort at a medium-term follow-up

Koçyiğit, Duygu; Gürses, Kadri Murat; Taydaş, Onur; Poker, Ahmet; Özer, Necla; Hazırolan, Tuncay; Tokgözoğlu, Lâle

doi:10.1016/j.jjcc.2019.09.012

Cited by 19 publications

(19 citation statements)

References 26 publications

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“…Femoral IMT is lesser studied as a marker for subclinical arteriosclerosis compared with carotid IMT. To our knowledge, only a single previous study has examined and demonstrated an association between femoral artery IMT and major adverse cardiovascular events in non-CKD patients [29], and no data in patients with CKD exist.…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular Determinants of Mortality in Advanced Chronic Kidney Disease

et al. 2020

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Background: Patients with advanced chronic kidney disease (CKD stage 4-5) have an increased risk of death. To study the determinants of all-cause mortality, we recruited 210 consecutive CKD stage 4-5 patients not on dialysis to the prospective Chronic Arterial Disease, quality of life and mortality in chronic KIDney injury (CADKID) study. Methods: One hundred seventy-four patients underwent maximal bicycle ergometry stress testing and lateral lumbar radiography to study abdominal aortic calcification score and echocardiography. Carotid and femoral artery intima-media thickness and elasticity and brachial artery flow-mediated dilatation were measured in 156 patients. Results: The duration of follow-up was 42 ± 17 months (range 134-2,217 days). The mean age was 61 ± 14 years, and the estimated glomerular filtration rate was 12 (11-15) mL/min/1.73 m 2. Thirty-six (21%) patients died during follow-up (time to death 835 ± 372 days). Seventy-five and 21 patients had diabetes and coronary artery disease, respectively, and all but one had hypertension. In the respective multivariate proportional hazards models adjusted for age, sex, and coronary artery disease, the significant determinants of mortality were troponin T, N-terminal pro-B-type natriuretic peptide, maximal ergometry performance, abdominal aortic calcification score, E/e′ ratio, and albumin. Conclusion: Stress ergometry performance, abdominal aortic calcification score, E/e′ of echocardiography, and plasma cardiac biomarkers and albumin predict mortality in advanced CKD.

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Section: Discussionmentioning

confidence: 99%

Cardiovascular Determinants of Mortality in Advanced Chronic Kidney Disease

et al. 2020

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“…23 Kocygit et al followed 215 subjects (mean age 54.85 years) for a median of 24 months and found that femoral plaques were independent predictors for CVEs. 24 Giannoukas et al reported that fIMT separately or in combination with cIMT was related to cardiovascular disease. 25 CIMT and AAI are well-established surrogate markers for subclinical atherosclerosis and strong predictors of future CVEs and mortality.…”

Section: Surrogate Markers For Atherosclerosismentioning

confidence: 99%

Prevalence of atherosclerosis and association with 5-year outcome: The Norwegian Stroke in the Young Study

Nawaz

Fromm

Øygarden

et al. 2021

European Stroke Journal

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Objectives: We studied the prevalence of atherosclerosis among ischaemic stroke patients ≤60 years and controls at the time of the index stroke, and its association with occurrence of new cardiovascular events (CVEs) and mortality at a 5-year follow-up. Methods: Prevalent atherosclerosis was assessed for 385 patients and 260 controls in seven vascular areas by electrocardiogram (ECG), ankle–arm index (AAI) and measurement of right and left carotid and femoral intima-media thickness (cIMT and fIMT) and abdominal aorta plaques (AAP). Clinical end-points were any new CVE (stroke, angina, myocardial infarction or peripheral arterial disease) or death from any cause at 5-year follow-up. All results were sex- and age-adjusted; logistic regression and Cox proportional hazards models were applied. Results: Young patients ≤49 years had prevalent atherosclerosis in 1/2 of males and 1/3 of females. Compared with controls, young female patients showed significantly higher prevalent atherosclerosis, p = 0.024. Ischaemic ECG and mean cIMT were higher in young and middle-aged female patients ( p = 0.044, p = 0.020, p = 0.023 and p <0.001, respectively). Mean fIMT was higher in middle-aged female patients ( p <0.001). Cardiovascular events were associated with ischaemic ECG; AAI ≤0.9, fIMT ≥0.9 mm and increased number of areas with atherosclerosis (NAA) among patients, and with AAP, cIMT ≥0.9 mm, fIMT ≥0.9 mm and NAA among controls. Mortality was associated with higher age, ischaemic ECG and NAA among patients, and cIMT ≥0.9 mm among controls. Conclusion: Atherosclerosis is highly prevalent even in young stroke patients. Some areas and increasing NAA are associated with CVEs and death.

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“…The risk equations included the following variables: (1) time period (10-y. ), (2) age (y. ), (3) sex (male/female), (4) smoking status (smoker/non-smoker) and/or number of cigarettes smoked/day, (5) diabetes (yes/no), (6) left ventricular hypertrophy on ECG (yes/no), (7) peripheral (brachial) systolic BP (pSBP; mmHg), (8) TC (mmol/L), (9) HDL (mmol/L) and/or (10) family history of premature CVD (yes/no).…”

Section: Lipid Ratios and 10 Y/cvr Scores Quantificationmentioning

confidence: 99%

“…Early detection and treatment of atherosclerotic disease might be central for improving cardiovascular (CV) prevention [1]. Plaques assessment with vascular imaging is an appealing strategy to aid in CV events' prediction and a potential tool for improving individual CV risk (CVR) stratification, enabling more efficient prevention [1][2][3][4][5]. Atherosclerotic load or burden (i.e., number of plaques and/or territories affected), is associated with (gradual) increase in CVR [3,6,7].…”

Section: Introductionmentioning

confidence: 99%

Carotid and Femoral Atherosclerotic Plaques in Asymptomatic and Non-Treated Subjects: Cardiovascular Risk Factors, 10-Years Risk Scores, and Lipid Ratios’ Capability to Detect Plaque Presence, Burden, Fibro-Lipid Composition and Geometry

Marin

Bia

Zócalo

2020

JCDD

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Carotid and/or femoral atherosclerotic plaques (AP) assessment through imaging studies is an interesting strategy for improving individual cardiovascular risk (CVR) stratification and cardiovascular disease (CVD) and/or events prediction. There is no consensus on who would benefit from image screening aimed at determining AP presence, burden, and characteristics. Aims: (1) to identify, in asymptomatic and non-treated subjects, demographic factors, anthropometric characteristics and cardiovascular risk factors (CRFs), individually or grouped (e.g., CVR equations, pro-atherogenic lipid ratios) associated with carotid and femoral AP presence, burden, geometry, and fibro-lipid content; (2) to identify cut-off values to be used when considering the variables as indicators of increased probability of AP presence, elevated atherosclerotic burden, and/or lipid content, in a selection scheme for subsequent image screening. Methods: CRFs exposure and clinical data were obtained (n = 581; n = 144 with AP; 47% females). Arterial (e.g., ultrasonography) and hemodynamic (central [cBP] and peripheral blood pressure; oscillometry/applanation tonometry) data were obtained. Carotid and femoral AP presence, burden (e.g., AP number, involved territories), geometric (area, width, height) and fibro-lipid content (semi-automatic, virtual histology analysis, grayscale analysis and color mapping) were assessed. Lipid profile was obtained. Lipid ratios (Total cholesterol/HDL-cholesterol, LDL-cholesterol/HDL-cholesterol, LogTryglicerides(TG)/HDL-cholesterol) and eight 10-years [y.]/CVR scores were quantified (e.g., Framingham Risk Scores [FRS] for CVD). Results: Age, 10-y./CVR and cBP showed the highest levels of association with AP presence and burden. Individually, classical CRFs and lipid ratios showed almost no association with AP presence. 10-y./CVR levels, age and cBP enabled detecting AP with large surfaces (˃p75th). Lipid ratios showed the largest association with AP fibro-lipid content. Ultrasound evaluation could be considered in asymptomatic and non-treated subjects aiming at population screening of AP (e.g., ˃ 45 y.; 10-y./FRS-CVD ˃ 5–8%); identifying subjects with high atherosclerotic burden (e.g., ˃50 y., 10-y./FRS-CVD ˃ 13–15%) and/or with plaques with high lipid content (e.g., LogTG/HDL ˃ 0.135).

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Role of femoral artery ultrasound imaging in cardiovascular event risk prediction in a primary prevention cohort at a medium-term follow-up

Cited by 19 publications

References 26 publications

Cardiovascular Determinants of Mortality in Advanced Chronic Kidney Disease

Cardiovascular Determinants of Mortality in Advanced Chronic Kidney Disease

Prevalence of atherosclerosis and association with 5-year outcome: The Norwegian Stroke in the Young Study

Carotid and Femoral Atherosclerotic Plaques in Asymptomatic and Non-Treated Subjects: Cardiovascular Risk Factors, 10-Years Risk Scores, and Lipid Ratios’ Capability to Detect Plaque Presence, Burden, Fibro-Lipid Composition and Geometry

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