Evaluation of carotid artery plaque density performed on serial ultrasound scans could help identify patients at high risk for a heart attack or other adverse cardiovascular events, according to Austrian researchers.
Evaluation of carotid artery plaque density performed on serial ultrasound scans could help identify patients at high risk for a heart attack or other adverse cardiovascular events, according to Austrian researchers.
Physicians know that the majority of cardiovascular and cerebrovascular events occur in patients whose blood vessels are less than 70% narrowed. Determining the degree of stenosis is thus insufficient to predict a patient's risk of suffering a heart attack or stroke, said lead researcher Dr. Markus Reiter of the department of angiography and interventional radiology at Medical University Vienna.
Reiter's team evaluated the complementary clinical value of computer-assisted gray-scale median (GSM) ultrasound measurements to determine carotid artery plaque density. Previous research suggested that plaque that appears dark on ultrasound images and has a low GSM level could be unstable and thus associated with an increased risk for clinical complications. Study results strengthened this theory.
"Patients with a reduction in GSM levels from their baseline ultrasound to the follow-up ultrasound exhibited a significantly increased risk for near-future adverse event compared with patients with increasing GSM levels," Reiter said.
Reiter and colleagues enrolled 1268 asymptomatic patients at high risk of cardiovascular disease who underwent GSM measurements of their carotids. Scans showed that 574 patients had carotid artery disease, based on their plaque volume. Each of those patients had a second ultrasound exam six to nine months later to measure plaque changes.
The investigators found that GSM levels decreased in 230 of patients at follow-up. Eighty-five (37%) of those patients experienced a major adverse cardiovascular event such as heart attack, stroke, cardiac surgery, or other intervention within three years of the second ultrasound. In 344 patients, GSM levels increased between the baseline and follow-up exams. Ninety-two (28%) of those patients suffered a major adverse cardiovascular event.
Results also showed that vulnerable plaque in the carotid artery was not only an indicator of increased risk of stroke but was also associated with disease progression elsewhere in the cardiovascular system. Study results will appear in the September issue of Radiology.
Additional studies are needed to validate these findings. In the meantime, however, measuring GSM levels on serial ultrasound scans may be a noninvasive way to identify the presence of vulnerable plaques and bolster therapeutic effectiveness, according to Reiter.
"This technique will give us additional information to use in selecting patients that need aggressive treatment," he said.
For more information from the Diagnostic Imaging archives:
Echo society issues rules for carotid ultrasound
Screening tackles hidden cardiovascular disease in retired football pros
Coronary CT angiography saves lives and money: 20,000-plus cases prove it
Contrast-enhanced ultrasound shows new marker for atherosclerosis
The Reading Room: Racial and Ethnic Minorities, Cancer Screenings, and COVID-19
November 3rd 2020In this podcast episode, Dr. Shalom Kalnicki, from Montefiore and Albert Einstein College of Medicine, discusses the disparities minority patients face with cancer screenings and what can be done to increase access during the pandemic.
Study Finds Transvaginal Ultrasound Unreliable for Detecting Endometrial Cancer in Black Patients
July 3rd 2024Utilizing a threshold of less than 5 mm of ultrasound-measured endometrial thickness, the authors of a new study noted an 11.4 percent false-negative probability for endometrial cancer in Black patients.
New Study Shows Non-Radiologists Interpreting 28 Percent of Imaging for Medicare Patients
June 28th 2024While radiologists interpreted approximately 99 percent of all non-cardiac CT, MRI and nuclear medicine studies in hospital and emergency department settings for Medicare beneficiaries, new research shows significantly less radiologist review of cardiac imaging and office-based imaging.
FDA Clears Pocket-Sized ECG System and AI Technology for Detection of Cardiac Conditions
June 27th 2024Using a reduced leadset and deep neural network algorithms trained on more than 175 million electrocardiograms, the KAI 12L technology reportedly detects up to 35 cardiac determinations, including acute myocardial infarction.