Tests help identify early cardiovascular disease

A carotid intima-media thickness (CIMT) evaluation can detect subclinical vascular disease in patients who have a low Framingham risk score (FRS) and a coronary artery calcium score (CACS) of 0. Two specific tests can identify early subclinical atherosclerosis: ultrasonography and CT.

Lester and colleagues evaluated a group of young to middle-aged patients who had at least 1 cardiovascular risk factor but no overt symptoms of cardiac disease. Ultrasonography of the carotid artery was used to detect plaque and measure CIMT, and CT determined calcification of the coronary artery and was used to calculate the CACS.

Of the 118 patients studied, 75% had a CACS of 0, and 97% were considered to be at low risk for a coronary event (low FRS). However, 47% of patients had evidence of carotid atherosclerosis and 34% had carotid plaque.

The authors noted that the high percentage of patients with a CACS of 0 and a CIMT indicating atherosclerosis supports the greater sensitivity of CIMT over CACS for detecting subclinical atherosclerosis in young to middle-aged patients who could most benefit from early efforts at coronary disease prevention.