Early Detection of Subclinical Atherosclerosis in Asymptomatic Patients Assessed by Carotid Duplex and Coronary Computed Tomography

Background: The objective of this study is to determine the presence of early-stage atherosclerosis and the determinants of those with abnormal intima-media thickness (IMT) without coronary calcification assessed by carotid duplex and coronary computed tomography in a relatively healthy population a...

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Main Authors: Cheng-Hsi Chen, Chung-Lieh Hung, Helen L. Po, Chun-Ho Yun, Yih-Jer Wu, Chuan-Chuan Liu, Jen-Yuan Kuo, Cheng-Ho Tsai, Hung-I Yeh
Format: Article
Language:English
Published: Taiwan Society of Geriatric Emergency and Critical Medicine (TSGECM) 2013-03-01
Series:International Journal of Gerontology
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S1873959812000725
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author Cheng-Hsi Chen
Chung-Lieh Hung
Helen L. Po
Chun-Ho Yun
Yih-Jer Wu
Chuan-Chuan Liu
Jen-Yuan Kuo
Cheng-Ho Tsai
Hung-I Yeh
author_facet Cheng-Hsi Chen
Chung-Lieh Hung
Helen L. Po
Chun-Ho Yun
Yih-Jer Wu
Chuan-Chuan Liu
Jen-Yuan Kuo
Cheng-Ho Tsai
Hung-I Yeh
author_sort Cheng-Hsi Chen
collection DOAJ
description Background: The objective of this study is to determine the presence of early-stage atherosclerosis and the determinants of those with abnormal intima-media thickness (IMT) without coronary calcification assessed by carotid duplex and coronary computed tomography in a relatively healthy population and to compare the results from the two detection methods. Materials and methods: Data of 181 asymptomatic participants [mean age 50.8 (35–72) years, 131 males] regarding baseline characteristics; blood biochemistries; Framingham risk score (FRS); metabolic score (MS); either carotid intima-media thickness (CIMT) or plaque, or both; and coronary artery calcification score (CACS) were obtained. Distributional differences between categorized atherosclerosis groups defined by various methods were compared using Chi-square test, while uni- and multivariate analyses were conducted to establish independent risk of atherosclerosis. Results: For all participants, the mean MS was 1.58 and mean FRS was 5.99. Zero CACS was found in 123 individuals, of whom 75 (61%) had abnormal CIMT or plaque existence. After adjusting the confounders, both male gender and larger BMI were found to be significantly associated with abnormal CIMT or plaque existence in patients with zero CACS in multivariable regression model. Conclusion: Carotid duplex may detect subclinical vascular atherosclerosis in more than half of asymptomatic patients without coronary artery calcification detected by coronary computed tomography. These findings have important implications for early-stage atherosclerosis screening and implementation of primary preventive intervention.
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spelling doaj.art-2d45e761eb384143bfd6f2bda8e9945e2022-12-21T21:51:47ZengTaiwan Society of Geriatric Emergency and Critical Medicine (TSGECM)International Journal of Gerontology1873-95982013-03-0171273410.1016/j.ijge.2012.05.004Early Detection of Subclinical Atherosclerosis in Asymptomatic Patients Assessed by Carotid Duplex and Coronary Computed TomographyCheng-Hsi Chen0Chung-Lieh Hung1Helen L. Po2Chun-Ho Yun3Yih-Jer Wu4Chuan-Chuan Liu5Jen-Yuan Kuo6Cheng-Ho Tsai7Hung-I Yeh8Division of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, TaiwanDivision of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, TaiwanDepartment of Neurology, Mackay Memorial Hospital, Taipei, TaiwanDepartment of Radiology, Mackay Memorial Hospital, Taipei, TaiwanDivision of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, TaiwanHealth Evaluation Center, Mackay Memorial Hospital, Taipei, TaiwanDivision of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, TaiwanDivision of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, TaiwanDivision of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, TaiwanBackground: The objective of this study is to determine the presence of early-stage atherosclerosis and the determinants of those with abnormal intima-media thickness (IMT) without coronary calcification assessed by carotid duplex and coronary computed tomography in a relatively healthy population and to compare the results from the two detection methods. Materials and methods: Data of 181 asymptomatic participants [mean age 50.8 (35–72) years, 131 males] regarding baseline characteristics; blood biochemistries; Framingham risk score (FRS); metabolic score (MS); either carotid intima-media thickness (CIMT) or plaque, or both; and coronary artery calcification score (CACS) were obtained. Distributional differences between categorized atherosclerosis groups defined by various methods were compared using Chi-square test, while uni- and multivariate analyses were conducted to establish independent risk of atherosclerosis. Results: For all participants, the mean MS was 1.58 and mean FRS was 5.99. Zero CACS was found in 123 individuals, of whom 75 (61%) had abnormal CIMT or plaque existence. After adjusting the confounders, both male gender and larger BMI were found to be significantly associated with abnormal CIMT or plaque existence in patients with zero CACS in multivariable regression model. Conclusion: Carotid duplex may detect subclinical vascular atherosclerosis in more than half of asymptomatic patients without coronary artery calcification detected by coronary computed tomography. These findings have important implications for early-stage atherosclerosis screening and implementation of primary preventive intervention.http://www.sciencedirect.com/science/article/pii/S1873959812000725cardiovascular diseasecarotid intima-media thicknesscomputed tomographycoronary artery calcium scoreFramingham risk score
spellingShingle Cheng-Hsi Chen
Chung-Lieh Hung
Helen L. Po
Chun-Ho Yun
Yih-Jer Wu
Chuan-Chuan Liu
Jen-Yuan Kuo
Cheng-Ho Tsai
Hung-I Yeh
Early Detection of Subclinical Atherosclerosis in Asymptomatic Patients Assessed by Carotid Duplex and Coronary Computed Tomography
International Journal of Gerontology
cardiovascular disease
carotid intima-media thickness
computed tomography
coronary artery calcium score
Framingham risk score
title Early Detection of Subclinical Atherosclerosis in Asymptomatic Patients Assessed by Carotid Duplex and Coronary Computed Tomography
title_full Early Detection of Subclinical Atherosclerosis in Asymptomatic Patients Assessed by Carotid Duplex and Coronary Computed Tomography
title_fullStr Early Detection of Subclinical Atherosclerosis in Asymptomatic Patients Assessed by Carotid Duplex and Coronary Computed Tomography
title_full_unstemmed Early Detection of Subclinical Atherosclerosis in Asymptomatic Patients Assessed by Carotid Duplex and Coronary Computed Tomography
title_short Early Detection of Subclinical Atherosclerosis in Asymptomatic Patients Assessed by Carotid Duplex and Coronary Computed Tomography
title_sort early detection of subclinical atherosclerosis in asymptomatic patients assessed by carotid duplex and coronary computed tomography
topic cardiovascular disease
carotid intima-media thickness
computed tomography
coronary artery calcium score
Framingham risk score
url http://www.sciencedirect.com/science/article/pii/S1873959812000725
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