title: ICEBERG: Intimal Carotid Evaluation Before Echocardiography Reveals Global Vascular Risk.
abstract: BACKGROUND
  There is growing evidence that carotid ultrasonography provides important prognostic information about cardiovascular risk assessment. Our objective was to determine whether abbreviated rapid carotid ultrasonographic screening would reveal important global vascular risk information in statin-naive patients referred for routine transthoracic echocardiography (TTE).
  
  
  METHODS
  Abbreviated carotid ultrasonographic imaging was performed in 560 consecutive patients undergoing TTE. The common carotid artery (CCA), the carotid bulb, and the internal carotid artery (ICA) were scanned. Maximal CCA intima-media thickness (IMT) was measured in the far wall. Carotid plaque was defined using the Atherosclerosis Risk in Communities (ARIC) study criteria.
  
  
  RESULTS
  Of the 2283 patients who underwent TTE during a 1-year period, a total of 560 patients met inclusion criteria. There were 241 men, with a mean age of 63.2 ± 12.8 years and a mean CCA IMT of 1.11 ± 0.48 mm; 61% (147) had carotid plaque. The 319 women had a mean age of 66.3 ± 10.8 years and a mean CCA IMT of 1.03 ± 0.36 mm; 62.4% (199) had carotid plaque. All patients with plaque were considered to be at high risk.
  
  
  CONCLUSIONS
  Of the 560 consecutive statin-naive patients referred for TTE with no history of vascular disease, a large proportion of both men (61%) and women (62.4%) had carotid plaque, indicating a high risk for vascular events according to the Canadian lipid guidelines. Although such patients are seen in the echocardiography laboratory, the addition of an abbreviated carotid ultrasonographic screening provides important information regarding risk stratification and the implementation of preventive therapy.
authors.affiliation: Division of Cardiology, Queen's University, Kingston, Ontario, Canada.
authors.forename: Amer M
authors.initials: AM
authors.lastname: Johri
authors.affiliation: The Kingston Heart Clinic, Kingston, Ontario, Canada.
authors.forename: David W J
authors.initials: DW
authors.lastname: Armstrong
authors.affiliation: The Kingston Heart Clinic, Kingston, Ontario, Canada.
authors.forename: Ursula
authors.initials: U
authors.lastname: Jurt
authors.affiliation: The Kingston Heart Clinic, Kingston, Ontario, Canada.
authors.forename: Daniel
authors.initials: D
authors.lastname: Brouillard
authors.affiliation: The Kingston Heart Clinic, Kingston, Ontario, Canada. Electronic address: murraymatangi@hotmail.com.
authors.forename: Murray F
authors.initials: MF
authors.lastname: Matangi
mesh_terms: D000368:Aged; D002339:Carotid Arteries / Q000000981:diagnostic imaging*; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging; D059168:Carotid Intima-Media Thickness / Q000592:standards; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment