From Vulnerable Plaque to Vulnerable Patient—Part III: Executive Summary of the Screening for Heart Attack Prevention and Education (SHAPE) Task Force Report (original) (raw)
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Journal of the American College of Cardiology, 2015
Although recent studies suggest that measuring coronary artery calcification (CAC) may be superior to indirect atherosclerotic markers in predicting cardiac risk, there are limited data evaluating imaging-based biomarkers that directly quantify atherosclerosis in different vascular beds performed in a single cohort. The BioImage Study (A Clinical Study of Burden of Atherosclerotic Disease in an At-Risk Population) sought to identify imaging biomarkers that predict near-term (3-year) atherothrombotic events. The BioImage Study enrolled 5,808 asymptomatic U.S. adults (mean age: 69 years, 56.5% female) in a prospective cohort evaluating the role of vascular imaging on cardiovascular risk prediction. All patients were evaluated by CAC and novel 3-dimensional carotid ultrasound. Plaque areas from both carotid arteries were summed as the carotid plaque burden (cPB). The primary endpoint was the composite of major adverse cardiac events (MACE) (cardiovascular death, myocardial infarction, ...
Significance of Subclinical Atherosclerosis in Cardiovascular Risk Assessment
2016
Background: The current recommendation for risk stratification of the new ACC/AHA guidelines on cholesterol therapy to reduceatherosclerotic cardiovascular risk questions the usefulness of subclinical atherosclerosis detection in primary prevention.Objectives: The aim of this study was to analyze the prevalence of subclinical atherosclerosis assessed by carotid echocardiographyin the different risk groups according to the new guidelines, and to evaluate the prevalence of subclinical atherosclerosis in the differentsubgroups when a sub-stratification based on the number of risk factors is added.Methods: Consecutive primary prevention patients were selected. Patients with a history of diabetes and/or coronary artery diseaseand/or peripheral vascular disease were excluded from the study. Subclinical atherosclerosis was defined as the presence of one ormore atherosclerotic plaques detected by carotid Doppler echocardiography.Results: Five hundred and forty one patients were analyzed; 24...
Current Atherosclerosis Reports, 2011
The High-Risk Plaque (HRP) Initiative is a research and development effort to advance the understanding, recognition, and management of asymptomatic individuals at risk for a near-term atherothrombotic event such as myocardial infarction or stroke. Clinical studies using the newest technologies have been initiated, including the BioImage Study in which novel approaches are tested in a typical health plan population. Asymptomatic at-risk individuals were enrolled, including a survey-only group (n=865), a group undergoing traditional risk factor scoring (n=718), and a group in which all were assessed for both risk factors and subclinical atherosclerosis (n=6104). The latter two groups underwent baseline examination in a dedicated mobile facility equipped with advanced imaging tools suitable for noninvasive screening for subclinical atherosclerosis (coronary artery calcium by computed tomography [CT], carotid and aortic disease by ultrasound, and ankle-brachial index). Selected participants were offered advanced imaging (contrast-enhanced CT, magnetic resonance imaging, and positron emission tomography/CT). Plasma, PAXgene RNA, and DNA samples were obtained for biomarker discovery studies. All individuals will be followed until 600 major atherothrombotic events have occurred in those undergoing imaging.