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The relationship between carotid plaque area and cardiovascular outcomes.
05.18 - Carotid disease
M. Matangi1, DW. Armstrong1, U. Jurt1, D. Brouillard1, J. Bakker1, A. Dillon1, AM. Johri2 - (1) Kingston Heart Clinic, Kingston, Canada (2) Queen's University, Kingston, Canada
Purpose. To determine cardiovascular outcomes both mortality and morbidity in patients where carotid plaque area and plaque score had been measured. Methods. Males 40-70 years and females 50-70 years were selected. Patients with a minimum of 1 year of follow up were included. Patients with diabetes, taking a statin or a history of prior vascular disease were excluded. The first carotid examination was used for analysis. Patients or their surviving relatives were contacted by phone and any vascular events were confirmed by reviewing local hospital records, office records, or coroner’s records. As patients often had multiple vascular events, only the first vascular event was used in this analysis. In the case of cardiovascular death, the death was taken as the only event for that patient. Plaque area was measured offline using commercially available GE software in the carotid bulbs and internal carotid arteries. Patients were divided into 4 quartiles according to their total plaque area. The quartiles were as follows, 0mm2, 0-10.4mm2, 10.6-37.1mm2 and ≥37.2mm2. Statistical analysis was performed using ANOVA and Chi-squared analysis. A P value of <0.05 was considered significant. Results. See Table 1. There were 1,253 patients who were studied and followed for an average of 4 years (1-8 years). These 1,253 patients experienced 58 cardiovascular events, including 7 cardiovascular deaths. The majority of events (46, 79.3%) including 6 cardiovascular deaths occurred in the 3rd and 4th quartiles. A plaque area <10.4mm2 is associated with a low cardiovascular event rate, approximately 0.48% per year compared to 1.83% per year for patients’ with a plaque area of >10.4mm2 and 2.39% per year for patients with a plaque area >37.2mm2. Conclusions. Plaque burden as represented by total either plaque area in the carotid bulb and internal carotid artery or plaque score are both good predictors of future adverse cardiovascular events.