ECHO 2013 / The Role of Vascular Imaging in Cardiovascular Risk Assessment

Compare to a normative data set.

ASE Consensus Statement: CV Risk

CVD Risk Increased

If CIMT ≥ 75th percentile for age, race, sex

If carotid plaque is present

Greater than 50% protrusion

Focal CIMT > 1.5 mm

CVD Risk Average (unchanged)

CIMT in the 25th to 75th percentile

CVD Risk Lower

CIMT ≤ 25th percentile

SAIP

Appropriate

Use Criteria

Summary

Increased cIMT predicts CV events

Carotid plaque probably does this better than cIMT alone

Plaque presence may modify behavior (smoking cessation, lifestyle changes)

Treatment with statins slows progression of cIMT and can reduce TPA

cIMT and plaque can help improved CHD risk prediction, but only modestly

The Unanswered Question

How effective can reclassification be?

Does screening and subsequent intensification of medical regimens in patients with plaque or increased CIMT prevents cardiovascular events?

Is this strategy cost-effective?

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