Carotid total plaque area as an independent predictor of short-term subclinical polyvascular atherosclerosis progression and major adverse cardiac and cerebrovascular events

Background: The use of ultrasound-based methods for imaging of subclinical atherosclerosis, including measurement of carotid plaque burden (cPB), is a promising direction for further improvement of major adverse cardiac and cerebrovascular events (MACCE) prediction. Objectives: The aim of the study...

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Main Authors: Vadim Genkel, Alla Kuznetsova, Evgeniy Lebedev, Alexey Salashenko, Albina Savochkina, Karina Nikushkina, Lubov Pykhova, Veronika Sumerkina, Igor Shaposhnik
Format: Article
Language:English
Published: SAGE Publishing 2023-09-01
Series:Therapeutic Advances in Cardiovascular Disease
Online Access:https://doi.org/10.1177/17539447231194861
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author Vadim Genkel
Alla Kuznetsova
Evgeniy Lebedev
Alexey Salashenko
Albina Savochkina
Karina Nikushkina
Lubov Pykhova
Veronika Sumerkina
Igor Shaposhnik
author_facet Vadim Genkel
Alla Kuznetsova
Evgeniy Lebedev
Alexey Salashenko
Albina Savochkina
Karina Nikushkina
Lubov Pykhova
Veronika Sumerkina
Igor Shaposhnik
author_sort Vadim Genkel
collection DOAJ
description Background: The use of ultrasound-based methods for imaging of subclinical atherosclerosis, including measurement of carotid plaque burden (cPB), is a promising direction for further improvement of major adverse cardiac and cerebrovascular events (MACCE) prediction. Objectives: The aim of the study was to research the prognostic values’ significance of cPB indicators with regard to the short-term progression of polyvascular subclinical atherosclerosis and the long-term onset of MACCE. Design: Single-center prospective cohort study. Methods: The study included patients 40–64 years of age. All patients underwent duplex scanning (DS) of the carotid and lower limb arteries. The following cPB indicators were determined: carotid plaque score (cPS), maximum carotid plaque thickness (cPTmax), and carotid total plaque area (cTPA). The combined endpoint included the following components: cardiovascular death; nonfatal myocardial infarction; nonfatal stroke or transient ischemic attack (TIA); revascularization of the coronary and/or peripheral arteries. Results: The study included 387 patients, among whom 142 (36.7%) patients underwent repeated DS after 12–24 months. The median follow-up time was 20.0 (13.0; 36.5) months. MACCE were recorded in 33 (8.52%) of patients. cTPA and cPTmax, but not cPS, were independently associated with the progression of subclinical polyvascular atherosclerosis over a period of 13.9 months of follow-up. cTPA, but not cPTmax and cPS, was independently associated with the development of MACCE over a period of 20.0 months of follow-up. Only a cTPA > 42.0 mm 2 proved to be an independent predictor of both the progression of subclinical polyvascular atherosclerosis and MACCE. Conclusion: In patients from 40 to 64 years of age with various cardiovascular risks, among the indicators of the cPB, only an increase in cTPA > 42.0 mm 2 was shown to be independently associated with an increase in the relative risk (RR) of progression of subclinical polyvascular atherosclerosis by 2.38 (1.08–5.25) times, as well as with the development of MACCE by 3.10 (1.54–6.26) times.
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spelling doaj.art-9725b5fefb2845c5af0db0b7cddda1af2023-09-01T17:33:40ZengSAGE PublishingTherapeutic Advances in Cardiovascular Disease1753-94552023-09-011710.1177/17539447231194861Carotid total plaque area as an independent predictor of short-term subclinical polyvascular atherosclerosis progression and major adverse cardiac and cerebrovascular eventsVadim GenkelAlla KuznetsovaEvgeniy LebedevAlexey SalashenkoAlbina SavochkinaKarina NikushkinaLubov PykhovaVeronika SumerkinaIgor ShaposhnikBackground: The use of ultrasound-based methods for imaging of subclinical atherosclerosis, including measurement of carotid plaque burden (cPB), is a promising direction for further improvement of major adverse cardiac and cerebrovascular events (MACCE) prediction. Objectives: The aim of the study was to research the prognostic values’ significance of cPB indicators with regard to the short-term progression of polyvascular subclinical atherosclerosis and the long-term onset of MACCE. Design: Single-center prospective cohort study. Methods: The study included patients 40–64 years of age. All patients underwent duplex scanning (DS) of the carotid and lower limb arteries. The following cPB indicators were determined: carotid plaque score (cPS), maximum carotid plaque thickness (cPTmax), and carotid total plaque area (cTPA). The combined endpoint included the following components: cardiovascular death; nonfatal myocardial infarction; nonfatal stroke or transient ischemic attack (TIA); revascularization of the coronary and/or peripheral arteries. Results: The study included 387 patients, among whom 142 (36.7%) patients underwent repeated DS after 12–24 months. The median follow-up time was 20.0 (13.0; 36.5) months. MACCE were recorded in 33 (8.52%) of patients. cTPA and cPTmax, but not cPS, were independently associated with the progression of subclinical polyvascular atherosclerosis over a period of 13.9 months of follow-up. cTPA, but not cPTmax and cPS, was independently associated with the development of MACCE over a period of 20.0 months of follow-up. Only a cTPA > 42.0 mm 2 proved to be an independent predictor of both the progression of subclinical polyvascular atherosclerosis and MACCE. Conclusion: In patients from 40 to 64 years of age with various cardiovascular risks, among the indicators of the cPB, only an increase in cTPA > 42.0 mm 2 was shown to be independently associated with an increase in the relative risk (RR) of progression of subclinical polyvascular atherosclerosis by 2.38 (1.08–5.25) times, as well as with the development of MACCE by 3.10 (1.54–6.26) times.https://doi.org/10.1177/17539447231194861
spellingShingle Vadim Genkel
Alla Kuznetsova
Evgeniy Lebedev
Alexey Salashenko
Albina Savochkina
Karina Nikushkina
Lubov Pykhova
Veronika Sumerkina
Igor Shaposhnik
Carotid total plaque area as an independent predictor of short-term subclinical polyvascular atherosclerosis progression and major adverse cardiac and cerebrovascular events
Therapeutic Advances in Cardiovascular Disease
title Carotid total plaque area as an independent predictor of short-term subclinical polyvascular atherosclerosis progression and major adverse cardiac and cerebrovascular events
title_full Carotid total plaque area as an independent predictor of short-term subclinical polyvascular atherosclerosis progression and major adverse cardiac and cerebrovascular events
title_fullStr Carotid total plaque area as an independent predictor of short-term subclinical polyvascular atherosclerosis progression and major adverse cardiac and cerebrovascular events
title_full_unstemmed Carotid total plaque area as an independent predictor of short-term subclinical polyvascular atherosclerosis progression and major adverse cardiac and cerebrovascular events
title_short Carotid total plaque area as an independent predictor of short-term subclinical polyvascular atherosclerosis progression and major adverse cardiac and cerebrovascular events
title_sort carotid total plaque area as an independent predictor of short term subclinical polyvascular atherosclerosis progression and major adverse cardiac and cerebrovascular events
url https://doi.org/10.1177/17539447231194861
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