Carotid total plaque area as an independent predictor of short-term subclinical polyvascular atherosclerosis progression and major adverse cardiac and cerebrovascular events

Vadim Genkel; Alla Kuznetsova; Evgeniy Lebedev; Alexey Salashenko; Albina Savochkina; Karina Nikushkina; Lubov Pykhova; Veronika Sumerkina; Igor Shaposhnik

doi:10.1177/17539447231194861

Carotid total plaque area as an independent predictor of short-term subclinical polyvascular atherosclerosis progression and major adverse cardiac and cerebrovascular events

Ther Adv Cardiovasc Dis. 2023 Jan-Dec:17:17539447231194861. doi: 10.1177/17539447231194861.

Authors

Vadim Genkel¹, Alla Kuznetsova², Evgeniy Lebedev^{2

3}, Alexey Salashenko², Albina Savochkina², Karina Nikushkina², Lubov Pykhova², Veronika Sumerkina², Igor Shaposhnik²

Affiliations

¹ Federal State Budgetary Educational Institution of Higher Education 'South-Ural State Medical University' of the Ministry of Healthcare of the Russian Federation, Vorovskogo street 64, Chelyabinsk 454092, Russia.
² Federal State Budgetary Educational Institution of Higher Education 'South-Ural State Medical University' of the Ministry of Healthcare of the Russian Federation, Chelyabinsk, Russia.
³ State Autonomous Health Care Institution Order of the Red Banner of Labor 'City Clinical Hospital No. 1 of Chelyabinsk', Chelyabinsk, Russia.

Abstract

Background: The use of ultrasound-based methods for imaging of subclinical atherosclerosis, including measurement of carotid plaque burden (cPB), is a promising direction for further improvement of major adverse cardiac and cerebrovascular events (MACCE) prediction.

Objectives: The aim of the study was to research the prognostic values' significance of cPB indicators with regard to the short-term progression of polyvascular subclinical atherosclerosis and the long-term onset of MACCE.

Design: Single-center prospective cohort study.

Methods: The study included patients 40-64 years of age. All patients underwent duplex scanning (DS) of the carotid and lower limb arteries. The following cPB indicators were determined: carotid plaque score (cPS), maximum carotid plaque thickness (cPTmax), and carotid total plaque area (cTPA). The combined endpoint included the following components: cardiovascular death; nonfatal myocardial infarction; nonfatal stroke or transient ischemic attack (TIA); revascularization of the coronary and/or peripheral arteries.

Results: The study included 387 patients, among whom 142 (36.7%) patients underwent repeated DS after 12-24 months. The median follow-up time was 20.0 (13.0; 36.5) months. MACCE were recorded in 33 (8.52%) of patients. cTPA and cPTmax, but not cPS, were independently associated with the progression of subclinical polyvascular atherosclerosis over a period of 13.9 months of follow-up. cTPA, but not cPTmax and cPS, was independently associated with the development of MACCE over a period of 20.0 months of follow-up. Only a cTPA > 42.0 mm² proved to be an independent predictor of both the progression of subclinical polyvascular atherosclerosis and MACCE.

Conclusion: In patients from 40 to 64 years of age with various cardiovascular risks, among the indicators of the cPB, only an increase in cTPA > 42.0 mm² was shown to be independently associated with an increase in the relative risk (RR) of progression of subclinical polyvascular atherosclerosis by 2.38 (1.08-5.25) times, as well as with the development of MACCE by 3.10 (1.54-6.26) times.

Keywords: carotid plaque burden; major adverse cardiovascular events; plaque area; plaque thickness.

MeSH terms

Atherosclerosis* / diagnostic imaging
Carotid Artery Diseases* / complications
Carotid Artery Diseases* / diagnostic imaging
Humans
Plaque, Atherosclerotic* / complications
Prospective Studies
Risk Factors
Stroke*