The role of carotid ultrasound for cardiovascular risk stratification beyond traditional risk factors.
Primary prevention and early detection of cardiovascular disease is important, as it is the leading cause of death throughout world. Risk stratification algorithms, such as Framingham Risk Score and European Systematic Coronary Risk Evaluation, that utilize a combination of various traditional risk factors have been developed to improve primary prevention. However, the accuracy of these algorithms for screening high risk patients is moderate at best. Accordingly, the use of biomarkers or imaging studies may improve risk stratification. Carotid ultrasound, which measures both carotid intima-media thichkness (cIMT) and carotid plaque, is useful in detecting the degree of subclinical carotid atherosclerosis, and has the advantage of being noninvasive and safe. Several large epidemiologic studies have indicated that cIMT and carotid plaque are closely related with other cardiovascular risk factors and may be useful for risk reclassification in subjects deemed to be at intermediate risk by traditional risk scores. Moreover, recent clinical guidelines for management of hypertension or dyslipidemia highlight the usefulness of cIMT in high risk patients. In this article, we review evidence for the usefulness of measurement of cIMT and carotid plaque for cardiovascular risk stratification.
Department of Biochemistry and Molecular Biology, Institute of Genetic Science, Integrated Genomic Research Center for Metabolic Regulation, BK21 Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea.
Chan Joo
CJ
Lee
Division of Cardiology, Yonsei Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea.
Sungha
S
Park
D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging* / Q000473:pathology*; D059168:Carotid Intima-Media Thickness; D006801:Humans; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging* / Q000473:pathology*; D012307:Risk Factors
Carotid intima-media thickness; atherosclerosis; cardiovascular diseases; carotid plaque; primary prevention