title: Impact of carotid plaque screening on smoking cessation and other cardiovascular risk factors: a randomized controlled trial.
abstract: BACKGROUND
  Screening of peripheral atherosclerosis is increasingly used, but few trials have examined its clinical impact. We aimed to assess whether carotid plaque screening helps smokers to improve their health behaviors and cardiovascular risk factors.
  
  
  METHODS
  We randomly assigned 536 smokers aged 40 to 70 years to carotid plaque ultrasonographic screening (US group) vs no screening (control group) in addition to individual counseling and nicotine replacement therapy for all participants. Smokers with at least 1 plaque received pictures of their plaques with a 7-minute structured explanation. The outcomes included biochemically validated smoking cessation at 12 months (primary outcome) and changes in cardiovascular risk factor levels and Framingham risk score.
  
  
  RESULTS
  At baseline, participants (mean age, 51.1 years; 45.0% women) smoked an average of 20 cigarettes per day with a median duration of 32 years. The US group had a high prevalence of carotid plaques (57.9%). At 12 months, smoking cessation rates were high, but did not differ between the US and control groups (24.9% vs 22.1%; P = .45). In the US group, cessation rates did not differ according to the presence or absence of plaques. Control of cardiovascular risk factors (ie, blood pressure and low-density lipoprotein cholesterol and hemoglobin A(1c) levels in diabetic patients) and mean absolute risk change in Framingham risk score did not differ between the groups. The mean absolute risk change in Framingham risk score was +0.6 in the US group vs +0.3 in the control group (P = .56).
  
  
  CONCLUSIONS
  In smokers, carotid plaque screening performed in addition to thorough smoking cessation counseling is not associated with increased rates of smoking cessation or control of cardiovascular risk factors. Trial Registration  clinicaltrials.gov Identifier: NCT00548665.
authors.affiliation: Department of General Internal Medicine, University Hospital Inselspital, University of Bern, Bern, Switzerland. Nicolas.Rodondi@insel.ch
authors.forename: Nicolas
authors.initials: N
authors.lastname: Rodondi
authors.forename: Tinh-Hai
authors.initials: TH
authors.lastname: Collet
authors.forename: David
authors.initials: D
authors.lastname: Nanchen
authors.forename: Isabella
authors.initials: I
authors.lastname: Locatelli
authors.forename: Michèle
authors.initials: M
authors.lastname: Depairon
authors.forename: Drahomir
authors.initials: D
authors.lastname: Aujesky
authors.forename: Pascal
authors.initials: P
authors.lastname: Bovet
authors.forename: Jacques
authors.initials: J
authors.lastname: Cornuz
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology / Q000523:psychology; D003376:Counseling / Q000379:methods; D005260:Female; D006801:Humans; D008077:Lipoproteins, LDL / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging*; D012307:Risk Factors; D012907:Smoking / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D016540:Smoking Cessation / Q000379:methods / Q000523:psychology; D061485:Tobacco Use Cessation Devices; D016896:Treatment Outcome; D014463:Ultrasonography
chemical_list: D008077:Lipoproteins, LDL