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Subclinical carotid atherosclerosis in patients with traditional cardiovascular risk factors

Katamadze N. O., Laznam S. S., Bershtein L. L., Grishkin Yu. N.

Keywords: atherosclerosis, cardiovascular risk, carotid arterie

DOI: 10.18087/rhj.2013.3.1764

Background. It is well known that atherosclerosis starts long before appearance of symptoms (subclinical or preclinical atherosclerosis). For this reason, growing attention has been given to prevention of atherosclerotic conditions including identification of individuals with high risk of cardiovascular complications at the preclinical stage. Aim. Evaluating the prevalence of carotid atherosclerosis in asymptomatic individuals and studying the interrelation between the extent of subclinical atherosclerosis and traditional cardiovascular risk factors. Materials and methods. 79 patients (37 females and 42 males) aging 54.81±8.36 years without documented IHD, who had one or more traditional cardiovascular risk factors, were examined. Extent of subclinical atherosclerosis was assessed during ultrasound examination of extracranial carotid artery segments. Atherosclerosis markers included intima-media thickness (IMT), presence of an atherosclerotic plaque, and total atherosclerotic plaque area (TAPA). Results. The largest IMP was observed in the common carotid bifurcation. Atherosclerotic plaques were found in 35 (44.3 %) patients. Age, smoking status and number of RF were the factors most strongly influencing IMT and TAPA. A consistent interrelation was found between the SCORE grade of traditional cardiovascular risk factors and the extent of atherosclerotic alterations in carotid arteries. However a high risk of carotid atherosclerotic plaque (ASP) was not confirmed in 45 % of 29 potential candidates for primary cardiovascular prophylaxis by administration of lipid-lowering therapy. On the other hand, 15 patients did not require statins even after life style modification; however 3 (20 %) of them were diagnosed with ASPs indicating a high cardiovascular risk. Conclusion. Ultrasound imaging of carotid atherosclerosis markers supplements and specifies the information obtained by evaluation of traditional cardiovascular risk factors.
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Katamadze N. O., Laznam S. S., Bershtein L. L. et al. Subclinical carotid atherosclerosis in patients with traditional cardiovascular risk factors. Russian Heart Journal. 2013;12(3):135-141

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