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ICEBERG, cardiovascular outcomes data according to a baseline carotid ultrasound in 1,449 patients
Initial Carotid Evaluation Before Echocardiography Reveals Global risk
Not Member of EACPR
DW. Armstrong1, AM. Johri2, U. Jurt1, D. Brouillard1, M. Matangi1- (1) Kingston Heart Clinic, Kingston, Canada (2) Queen's University, Kingston, Canada
Purpose. The purpose of this analysis was to determine the outcome with respect to cardiovascular mortality and morbidity of patients both with and without carotid plaque at baseline. Methods. Our carotid database was searched. Only 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 or taking a Statin at baseline were excluded. Patients with a history of any prior vascular event were also excluded. Only the first carotid examination was used. 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 time to first vascular event was used in this analysis. In the case of cardiovascular death time to death was used as the only endpoint. A normal carotid at baseline was defined as the absence of carotid plaque using the ARIC definition and a maximal CCA IMT of <1.00mm. Patients were followed for a mean of 3.7 years (range 1-8 years). Results. Follow up was possible and completed in 90% of patients, numbering 1,449. There were 2 events in the 357 normal carotids and 64 events in 1092 abnormal carotids. See figure 1. In the normal carotid group there was 1 MI and 1 CABG. In the abnormal group there were 6 cardiovascular deaths, 7 MIs, 21 CABGs, 17 PCIs, 3 strokes, 3 carotid endarterectomies, 3 AAA repairs, 3 peripheral angioplasties and 1 ICD implant. Conclusions. A normal carotid at baseline is associated with a very low cardiac event rate (0.15%/year) and in our cohort no cardiovascular deaths. An abnormal carotid is associated with a 10 fold increase (1.54%/year) in cardiovascular events including cardiovascular mortality.