Counterpoint: carotid ultrasound-an essential investigation in the prevention of coronary artery disease?
The accompanying article asserts that measurement of carotid plaque area by ultrasonography adds a vital, new dimension to the investigation and management of patients at risk of developing coronary artery disease. The author contends also that traditional risk factors for coronary artery disease have failed to provide a basis for either predicting cardiovascular events or guiding effective therapy. Carefully acquired epidemiological data have established beyond reasonable doubt that traditional risk factors identify individuals who are likely to develop coronary artery disease. Further, effective management of these factors have been remarkably effective in preventing cardiovascular events. There is little prospective data in randomly selected populations to indicate that ultrasound examinations of the carotid arteries provides additional new information which would argue in favor of an alternative therapeutic approach for patients likely to develop coronary artery disease.
Kappagoda
C Tissa
CT
Division of Cardiovascular Medicine, University of California, Davis, Sacramento, CA 95817, USA. ctkappagoda@ucdavis.edu
D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000517:prevention & control*; D006801:Humans; D011237:Predictive Value of Tests; D012307:Risk Factors; D014463:Ultrasonography