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CAROTID DISEASE IN PATIENTS WITH LOW AND INTERMEDIATE FRAMINGHAM RISK SCORES.

PosterTitle: The Prevalence of Carotid Disease in Patients with Low and IntermediateFramingham Risk Scores 

 

Author(s): Matangi M.F.1, Armstrong D.W.1, Nault M.1, Brouillard D.1

Institute(s): 1Kingston Heart Clinic, Kingston, Canada 

Purpose: To determine the prevalence of carotid disease in patients (P) presenting to

the Kingston Heart Clinic who are classified as either low or intermediate risk using the

Framingham risk score (FRS).

 

Methods: CAROTIDfile and NOTEfile, the carotid imaging and patient follow up

modules of CARDIOfile, our cardiology database were searched for all P who had both

carotid duplex imaging and calculation of their FRS. P with a score of < 10% were

deemed low FRS and those with a score of 10-19% were deemed intermediate FRS.

Maximal intimal medial thickness (IMT) was measured manually in the far wall of the

common carotid artery (CCA). An IMT of >1.0mm was considered abnormal and an

IMT ≤1.0mm was considered normal. Any degree of internal carotid stenosis was

determined using well established ISCAVL imaging and velocity criteria.

 

Results: There were 54 low FRS and 199 intermediate FRS P who fulfilled the entry

criteria. Results see Table 1.

 

Conclusions: The FRS likely underestimates the vascular risk for P presenting to the

Kingston Heart Clinic for cardiac assessment. Certainly our data indicates that the

majority of both low FRS and intermediate FRS P have evidence of significant carotid

vascular disease. Even if one excludes CCA IMT measurement and just refers to the

presence of obvious plaque, 55.6% of low FRS and 78.9% of intermediate FRS P have

obvious plaque. These P will most likely benefit from vascular protective therapies such

as Aspirin, Statins, and even perhaps ACE inhibitors. We advocate that all intermediate

FRS and most low FRS P undergo carotid duplex imaging.

 

 

Low FRS

Intermediate FRS

Number

54

199

Normal

19

31

IMT abnormal only

5

10

Any degree of carotid stenosis, bilateral

15

102

Any degree of stenosis, unilateral

15

57

Those with any carotid stenosis

30 (55.6%)

159 (78.9%)

% Abnormal

35 (64.8%)

169 (84.4%)

Table 1.