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Association of traditional risk factors with carotid intima-media thickness and carotid plaque in asymptomatic individuals with a family history of premature cardiovascular disease

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Abstract

The use of imaging to detect subclinical atherosclerosis helps to inform decision-making in people classified as having intermediate risk for cardiovascular disease (CVD). This study sought to use carotid plaque as an alternative to carotid intima media thickness (cIMT). Carotid ultrasound for assessment of cIMT and plaque was obtained in 1031 people (53 years, 61% female) with a family history of atherosclerotic CVD. The association of baseline characteristics and standard atherosclerotic risk factors (RFs) were sought with abnormal cIMT and plaque. The strongest association of plaque was a history of hypertension (odds ratio [OR] 1.87 (1.02–3.42), followed by age (OR 1.08 [95% CI 1.02–1.13]). For cIMT, the strongest association was smoking history (OR 1.57 [1.13–2.19]). The area under the receiver operator curve for the presence of plaque was 0.74 (95% CI 0.68–0.81, p < 0.001) and 0.65 (95% CI 0.61–0.70, p < 0.001) for cIMT elevation. Isolated elevation of cIMT (n = 178) was associated with increased total cholesterol, body mass index (BMI) and systolic blood pressure (SBP). Plaque only (n = 29) was associated with hypertension, male sex and older age. The presence of both markers abnormal (n = 22) was associated with a history of smoking. The absence of either abnormal cIMT or plaque (n = 773), was inversely associated with current or past smoking, SBP and BMI. Abnormalities in carotid vessels are present in a minority of intermediate risk patients with familial premature disease. The associations with RFs differ and are more closely associated with plaque.

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Funding

The IMPRESS study was funded by a NHMRC Program Grant 519823 awarded to the project investigators. SS is supported by the NHMRC of Australia (GNT1135894).

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Author notes

  1. The investigators acknowledge the significant contribution of Dr. Brian Haluska who died in February 2018.

Authors and Affiliations

  1. Baker Heart and Diabetes Institute, P.O. Box 6492, Melbourne, VIC, 3004, Australia

    Roberto Enrique Azcui Aparicio, Melinda J. Carrington & Thomas H. Marwick

  2. Torrens University Australia, Adelaide, Australia

    Roberto Enrique Azcui Aparicio, Melinda J. Carrington, Jocasta Ball, Simon Stewart & Thomas H. Marwick

  3. Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia

    Jocasta Ball

  4. Clinical Trials Unit, Canberra Hospital, Canberra, Australia

    Walter Abhayaratna

  5. Department of Medicine, University of Queensland, Brisbane, Australia

    Brian Haluska

Authors
  1. Roberto Enrique Azcui Aparicio
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  2. Melinda J. Carrington
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  3. Jocasta Ball
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  4. Walter Abhayaratna
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  6. Brian Haluska
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Correspondence to Thomas H. Marwick.

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Azcui Aparicio, R.E., Carrington, M.J., Ball, J. et al. Association of traditional risk factors with carotid intima-media thickness and carotid plaque in asymptomatic individuals with a family history of premature cardiovascular disease. Int J Cardiovasc Imaging 38, 739–749 (2022). https://doi.org/10.1007/s10554-021-02459-x

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  • DOI: https://doi.org/10.1007/s10554-021-02459-x

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