Ultrasound carotid plaque features, cardiovascular disease risk factors and events: The Multi-Ethnic Study of Atherosclerosis
It is not known if ultrasound carotid plaque features are associated with cardiovascular disease (CVD) risk factors or if they predict future CVD events. We measured total carotid plaque area (TPA) and grayscale plaque features (grayscale median, black areas, and discrete white areas) by B-mode caro...
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Published in | Atherosclerosis Vol. 276; pp. 195 - 202 |
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Main Authors | , , , , , , , , , |
Format | Journal Article |
Language | English |
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Ireland
Elsevier B.V
01.09.2018
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Abstract | It is not known if ultrasound carotid plaque features are associated with cardiovascular disease (CVD) risk factors or if they predict future CVD events.
We measured total carotid plaque area (TPA) and grayscale plaque features (grayscale median, black areas, and discrete white areas) by B-mode carotid ultrasound among 2205 participants who participated in the first (baseline) visit of the Multi-Ethnic Study of Atherosclerosis. Multivariable linear regression was used to examine relationships between ultrasound plaque features and CVD risk factors at baseline. Cox proportional hazards models were used to assess if TPA, grayscale features, and carotid plaque score (number of arterial segments with a plaque) could predict incident coronary heart disease and cerebrovascular disease events over a mean follow-up of 13.3 years.
Participants were mean (standard deviation [SD]) 65.4 (9.6) years, 49% male, 39% White, 11% Chinese, 28% Black, and 22% Hispanic. Mean TPA 27.7 (24.7) mm2, but no grayscale plaque features, was associated with CVD risk factors. In fully adjusted models, TPA but no grayscale features predicted incident coronary heart disease (CHD) events (HR 1.23; 95%CI 1.11–1.36; p<0.001), however, C-statistics for CHD were similar to carotid plaque score but less than for coronary artery calcium (CAC) scoring. Neither TPA nor grayscale features independently predicted cerebrovascular events.
In middle-aged adults free of known cardiovascular disease, TPA but not grayscale plaque features was associated with CVD risk factors and predicted incident CHD events. For CHD, prediction indices for TPA were similar to carotid plaque score but less than for CAC.
In middle-aged individuals free of known cardiovascular disease;•Total plaque area was associated with CHD risk factors and predicted incident CHD events.•Grayscale carotid plaque features did not predict incident CHD events.•For CHD, predictive characteristics of TPA were similar to carotid plaque score, but less than CAC score. |
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AbstractList | It is not known if ultrasound carotid plaque features are associated with cardiovascular disease (CVD) risk factors or if they predict future CVD events.BACKGROUND AND AIMSIt is not known if ultrasound carotid plaque features are associated with cardiovascular disease (CVD) risk factors or if they predict future CVD events.We measured total carotid plaque area (TPA) and grayscale plaque features (grayscale median, black areas, and discrete white areas) by B-mode carotid ultrasound among 2205 participants who participated in the first (baseline) visit of the Multi-Ethnic Study of Atherosclerosis. Multivariable linear regression was used to examine relationships between ultrasound plaque features and CVD risk factors at baseline. Cox proportional hazards models were used to assess if TPA, grayscale features, and carotid plaque score (number of arterial segments with a plaque) could predict incident coronary heart disease and cerebrovascular disease events over a mean follow-up of 13.3 years.METHODSWe measured total carotid plaque area (TPA) and grayscale plaque features (grayscale median, black areas, and discrete white areas) by B-mode carotid ultrasound among 2205 participants who participated in the first (baseline) visit of the Multi-Ethnic Study of Atherosclerosis. Multivariable linear regression was used to examine relationships between ultrasound plaque features and CVD risk factors at baseline. Cox proportional hazards models were used to assess if TPA, grayscale features, and carotid plaque score (number of arterial segments with a plaque) could predict incident coronary heart disease and cerebrovascular disease events over a mean follow-up of 13.3 years.Participants were mean (standard deviation [SD]) 65.4 (9.6) years, 49% male, 39% White, 11% Chinese, 28% Black, and 22% Hispanic. Mean TPA 27.7 (24.7) mm2, but no grayscale plaque features, was associated with CVD risk factors. In fully adjusted models, TPA but no grayscale features predicted incident coronary heart disease (CHD) events (HR 1.23; 95%CI 1.11-1.36; p<0.001), however, C-statistics for CHD were similar to carotid plaque score but less than for coronary artery calcium (CAC) scoring. Neither TPA nor grayscale features independently predicted cerebrovascular events.RESULTSParticipants were mean (standard deviation [SD]) 65.4 (9.6) years, 49% male, 39% White, 11% Chinese, 28% Black, and 22% Hispanic. Mean TPA 27.7 (24.7) mm2, but no grayscale plaque features, was associated with CVD risk factors. In fully adjusted models, TPA but no grayscale features predicted incident coronary heart disease (CHD) events (HR 1.23; 95%CI 1.11-1.36; p<0.001), however, C-statistics for CHD were similar to carotid plaque score but less than for coronary artery calcium (CAC) scoring. Neither TPA nor grayscale features independently predicted cerebrovascular events.In middle-aged adults free of known cardiovascular disease, TPA but not grayscale plaque features was associated with CVD risk factors and predicted incident CHD events. For CHD, prediction indices for TPA were similar to carotid plaque score but less than for CAC.CONCLUSIONSIn middle-aged adults free of known cardiovascular disease, TPA but not grayscale plaque features was associated with CVD risk factors and predicted incident CHD events. For CHD, prediction indices for TPA were similar to carotid plaque score but less than for CAC. It is not known if ultrasound carotid plaque features are associated with cardiovascular disease (CVD) risk factors or if they predict future CVD events. We measured total carotid plaque area (TPA) and grayscale plaque features (grayscale median, black areas, and discrete white areas) by B-mode carotid ultrasound among 2205 participants who participated in the first (baseline) visit of the Multi-Ethnic Study of Atherosclerosis. Multivariable linear regression was used to examine relationships between ultrasound plaque features and CVD risk factors at baseline. Cox proportional hazards models were used to assess if TPA, grayscale features, and carotid plaque score (number of arterial segments with a plaque) could predict incident coronary heart disease and cerebrovascular disease events over a mean follow-up of 13.3 years. Participants were mean (standard deviation [SD]) 65.4 (9.6) years, 49% male, 39% White, 11% Chinese, 28% Black, and 22% Hispanic. Mean TPA 27.7 (24.7) mm , but no grayscale plaque features, was associated with CVD risk factors. In fully adjusted models, TPA but no grayscale features predicted incident coronary heart disease (CHD) events (HR 1.23; 95%CI 1.11-1.36; p<0.001), however, C-statistics for CHD were similar to carotid plaque score but less than for coronary artery calcium (CAC) scoring. Neither TPA nor grayscale features independently predicted cerebrovascular events. In middle-aged adults free of known cardiovascular disease, TPA but not grayscale plaque features was associated with CVD risk factors and predicted incident CHD events. For CHD, prediction indices for TPA were similar to carotid plaque score but less than for CAC. It is not known if ultrasound carotid plaque features are associated with cardiovascular disease (CVD) risk factors or if they predict future CVD events. We measured total carotid plaque area (TPA) and grayscale plaque features (grayscale median, black areas, and discrete white areas) by B-mode carotid ultrasound among 2205 participants who participated in the first (baseline) visit of the Multi-Ethnic Study of Atherosclerosis. Multivariable linear regression was used to examine relationships between ultrasound plaque features and CVD risk factors at baseline. Cox proportional hazards models were used to assess if TPA, grayscale features, and carotid plaque score (number of arterial segments with a plaque) could predict incident coronary heart disease and cerebrovascular disease events over a mean follow-up of 13.3 years. Participants were mean (standard deviation [SD]) 65.4 (9.6) years, 49% male, 39% White, 11% Chinese, 28% Black, and 22% Hispanic. Mean TPA 27.7 (24.7) mm2, but no grayscale plaque features, was associated with CVD risk factors. In fully adjusted models, TPA but no grayscale features predicted incident coronary heart disease (CHD) events (HR 1.23; 95%CI 1.11–1.36; p<0.001), however, C-statistics for CHD were similar to carotid plaque score but less than for coronary artery calcium (CAC) scoring. Neither TPA nor grayscale features independently predicted cerebrovascular events. In middle-aged adults free of known cardiovascular disease, TPA but not grayscale plaque features was associated with CVD risk factors and predicted incident CHD events. For CHD, prediction indices for TPA were similar to carotid plaque score but less than for CAC. In middle-aged individuals free of known cardiovascular disease;•Total plaque area was associated with CHD risk factors and predicted incident CHD events.•Grayscale carotid plaque features did not predict incident CHD events.•For CHD, predictive characteristics of TPA were similar to carotid plaque score, but less than CAC score. |
Author | McClelland, Robyn L. Gepner, Adam D. Stein, James H. Mitchell, Carol Korcarz, Claudia E. Tracy, Russell Gassett, Amanda J. Ma, Nanxun Kaufman, Joel D. Post, Wendy |
AuthorAffiliation | e Departments of Pathology & Laboratory Medicine, Biochemistry Larner College of Medicine, University of Vermont, 360 South Park Drive, Colchester, VT, 05446, USA c Departments of Environmental & Occupational Health Sciences, Medicine, and Epidemiology, University of Washington, 4225 Roosevelt Way NE, Seattle, WA, 98105, USA d Division of Cardiology, Department of Medicine, Johns Hopkins University, 600 N. Wolfe Street, Baltimore MD, 21287, USA f Department of Environmental & Occupational Health Sciences, University of Washington, 1959 NE Pacific Street, Seattle, WA, 98195, USA a Department of Medicine, Division of Cardiovascular Medicine, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison WI, 53792, USA b William S. Middleton Memorial Veterans Hospital, 2500 Overlook Terrace, Madison, WI 53705, USA g Department of Biostatistics, University of Washington, 6200 NE 74 th Street, Seattle, WA, 98115, USA |
AuthorAffiliation_xml | – name: e Departments of Pathology & Laboratory Medicine, Biochemistry Larner College of Medicine, University of Vermont, 360 South Park Drive, Colchester, VT, 05446, USA – name: c Departments of Environmental & Occupational Health Sciences, Medicine, and Epidemiology, University of Washington, 4225 Roosevelt Way NE, Seattle, WA, 98105, USA – name: a Department of Medicine, Division of Cardiovascular Medicine, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison WI, 53792, USA – name: f Department of Environmental & Occupational Health Sciences, University of Washington, 1959 NE Pacific Street, Seattle, WA, 98195, USA – name: b William S. Middleton Memorial Veterans Hospital, 2500 Overlook Terrace, Madison, WI 53705, USA – name: d Division of Cardiology, Department of Medicine, Johns Hopkins University, 600 N. Wolfe Street, Baltimore MD, 21287, USA – name: g Department of Biostatistics, University of Washington, 6200 NE 74 th Street, Seattle, WA, 98115, USA |
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BackLink | https://www.ncbi.nlm.nih.gov/pubmed/29970256$$D View this record in MEDLINE/PubMed |
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Keywords | CRP GSM MESA BAB CAC TPA Carotid ultrasound Echogenicity ICC Cardiovascular disease TIA DWA CHD Plaque |
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Notes | ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 ObjectType-Undefined-3 Author Contributions Carol Mitchell and James Stein developed and designed the study to measure grayscale carotid plaque features. Claudia Korcarz performed data retrieval and developed the database for recording and archiving grayscale carotid plaque measurements. Robyn McClelland developed the statistical methods used in this study and helped interpret the results. Amanda Gassett and Nanxun Ma performed data/statistical analyses. Adam Gepner assisted with image analysis and data interpretation. Joel Kaufman, Wendy Post and Russell Tracy were responsible for interpreting MESA clinical reports and measures in preparation for statistical analyses. All authors assisted with writing of the manuscript. |
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Snippet | It is not known if ultrasound carotid plaque features are associated with cardiovascular disease (CVD) risk factors or if they predict future CVD events.
We... It is not known if ultrasound carotid plaque features are associated with cardiovascular disease (CVD) risk factors or if they predict future CVD... |
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SubjectTerms | Aged Aged, 80 and over Cardiovascular disease Carotid Arteries - diagnostic imaging Carotid Artery Diseases - diagnostic imaging Carotid Artery Diseases - ethnology Carotid Intima-Media Thickness Carotid ultrasound Cerebrovascular Disorders - diagnosis Cerebrovascular Disorders - ethnology Coronary Disease - diagnosis Coronary Disease - ethnology Echogenicity Female Humans Male Middle Aged Plaque Plaque, Atherosclerotic Predictive Value of Tests Prevalence Prognosis Risk Assessment Risk Factors United States - epidemiology |
Title | Ultrasound carotid plaque features, cardiovascular disease risk factors and events: The Multi-Ethnic Study of Atherosclerosis |
URI | https://dx.doi.org/10.1016/j.atherosclerosis.2018.06.005 https://www.ncbi.nlm.nih.gov/pubmed/29970256 https://www.proquest.com/docview/2064242610/abstract/ https://pubmed.ncbi.nlm.nih.gov/PMC7436944 |
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