Ultrasound-based markers of carotid atherosclerosis correlate well with the number of classical atherosclerotic risk factors

Abstract

Background and purpose

Ultrasound-based indicators such as mean or maximal carotid intima-media thickness (CIMT) and cross-sectional plaque area (C-SPA) have been shown to be measurable indices of atherosclerosis. We investigated whether those indicators correlated with the number of atherosclerotic risk factors assessed in routine clinical practice.

Materials and methods

The study involved a group of 150 patients (median age, 65 years). High-resolution ultrasound was used to assess CIMT and C-SPA of their common and internal carotid arteries. The number of risk factors derived from clinical examination (e.g., hypertension, diabetes, smoking), haematological test, acute phase proteins, serum lipoproteins, homocysteine, and body mass index was assessed.

Results

Plaques occurred in 85 patients (57% of participants). The median plaque area was 21 mm2 (10.7–46.5 mm2), and the mean CIMT was 0.88 mm (standard deviation, 0.28 mm). The study found significant associations among most of the single as well as the total number of risk factors and mean and maximal CIMT and C-SPA. The differences among the groups of patients with different numbers of risk factors were more evident in terms of the maximal and mean CIMT than in the case of C-SPA. Assessment of C-SPA could be statistically underpowered because only 57% of the investigated subjects had plaques in their carotid arteries.

Conclusions

We found a significant correlation between the total number of atherosclerosis risk factors and carotid atherosclerosis as measured by ultrasonography. Along with an increase of the number of risk factors, a gradual increase of CIMT and C-SPA was observed.