TY - JOUR
T1 - Presence of calcified carotid plaque predicts vascular events
T2 - The Northern Manhattan Study
AU - Prabhakaran, Shyam
AU - Singh, Rajinder
AU - Zhou, Xianhuang
AU - Ramas, Romel
AU - Sacco, Ralph L.
AU - Rundek, Tatjana
N1 - Copyright:
Copyright 2008 Elsevier B.V., All rights reserved.
PY - 2007/11
Y1 - 2007/11
N2 - Objective: The prognostic implications of carotid plaque calcification (CPC) relative to subsequent vascular events are unclear. Our aim was to determine the association between CPC and risk of vascular events in a prospective multi-ethnic cohort. Methods: CPC was assessed among 1118 stroke-free subjects (mean age 68 ± 8 years; 59% women; 59% Hispanic, 22% black, 19% white) from the Northern Manhattan Study using high-resolution B-mode ultrasound. CPC was defined by presence of any acoustic shadowing associated with carotid plaque, producing a reduction in echo amplitude due to intervening structures with high attenuation. Using Cox proportional hazards models, hazard ratios (HR) were estimated for the combined vascular outcome, defined as ischemic stroke (IS), myocardial infarction (MI) or vascular death (VD). Results: Carotid plaque was present in 637 (57%) subjects. CPC was present in 225 subjects (20% of total cohort; 35% of those with plaque). During a mean follow-up time of 2.7 years, the combined vascular outcome occurred among 52 subjects (20 IS, 22 MI, and 24 VD). Adjusting for demographics, major vascular risk factors, and carotid intima media thickness, those with CPC (in comparison to those without plaque) had a significantly increased risk of the combined vascular outcome (HR 2.5, 95% CI 1.0-5.8). Conclusions: In this population-based cohort, the presence of calcified carotid plaque, as assessed by high-resolution B-mode ultrasound, was an independent predictor of vascular events. It may serve as a simple and non-invasive marker of increased atherosclerotic risk and further aid in vascular risk stratification.
AB - Objective: The prognostic implications of carotid plaque calcification (CPC) relative to subsequent vascular events are unclear. Our aim was to determine the association between CPC and risk of vascular events in a prospective multi-ethnic cohort. Methods: CPC was assessed among 1118 stroke-free subjects (mean age 68 ± 8 years; 59% women; 59% Hispanic, 22% black, 19% white) from the Northern Manhattan Study using high-resolution B-mode ultrasound. CPC was defined by presence of any acoustic shadowing associated with carotid plaque, producing a reduction in echo amplitude due to intervening structures with high attenuation. Using Cox proportional hazards models, hazard ratios (HR) were estimated for the combined vascular outcome, defined as ischemic stroke (IS), myocardial infarction (MI) or vascular death (VD). Results: Carotid plaque was present in 637 (57%) subjects. CPC was present in 225 subjects (20% of total cohort; 35% of those with plaque). During a mean follow-up time of 2.7 years, the combined vascular outcome occurred among 52 subjects (20 IS, 22 MI, and 24 VD). Adjusting for demographics, major vascular risk factors, and carotid intima media thickness, those with CPC (in comparison to those without plaque) had a significantly increased risk of the combined vascular outcome (HR 2.5, 95% CI 1.0-5.8). Conclusions: In this population-based cohort, the presence of calcified carotid plaque, as assessed by high-resolution B-mode ultrasound, was an independent predictor of vascular events. It may serve as a simple and non-invasive marker of increased atherosclerotic risk and further aid in vascular risk stratification.
KW - Acoustic shadowing
KW - Plaque morphology
KW - Ultrasound
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U2 - 10.1016/j.atherosclerosis.2007.03.044
DO - 10.1016/j.atherosclerosis.2007.03.044
M3 - Article
C2 - 17482197
AN - SCOPUS:35248879189
VL - 195
SP - e197-e201
JO - Atherosclerosis
JF - Atherosclerosis
SN - 0021-9150
IS - 1
ER -