Assessments of Carotid Artery Plaque Burden in Patients With Familial Hypercholesterolemia

• Published in: The American journal of cardiology 2017-12, Vol.120 (11), p.1955-1960
• Main Authors: Tada, Hayato, Kawashiri, Masa-aki, Okada, Hirofumi, Nakahashi, Takuya, Sakata, Kenji, Nohara, Atsushi, Inazu, Akihiro, Mabuchi, Hiroshi, Yamagishi, Masakazu, Hayashi, Kenshi
• Format: Article
• Language: English
• Subjects: Adult; Arteriosclerosis; Atherosclerosis; Blood pressure; Cardiovascular disease; Carotid arteries; Carotid Arteries - diagnostic imaging; Carotid artery; Carotid Intima-Media Thickness; Carotid Stenosis - diagnosis; Carotid Stenosis - epidemiology; Carotid Stenosis - etiology; Cholesterol; Committees; Confidence intervals; Coronary artery; Coronary artery disease; Coronary vessels; Diabetes; Female; Follow-Up Studies; Gender; Heart diseases; Humans; Hypercholesterolemia; Hyperlipoproteinemia Type II - complications; Hyperlipoproteinemia Type II - diagnosis; Hypertension; Incidence; Japan - epidemiology; Low density lipoprotein; Male; Males; Mathematical models; Middle Aged; Mutation; Patients; Plaque, Atherosclerotic - complications; Plaque, Atherosclerotic - diagnosis; Regression analysis; Retrospective Studies; Risk analysis; Risk Assessment; Risk Factors; Statistical analysis; Ultrasound; Utilities
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2017.08.012

Although both carotid intima–media thickness (cIMT) and carotid plaque score (cPS) determined by carotid ultrasonography reflect the severity of coronary atherosclerosis, there are few reports on direct comparisons of their clinical utilities in patients with familial hypercholesterolemia (FH). We aimed (1) to compare the clinical utilities of these measurements and (2) to estimate the onset and progression of carotid atherosclerosis in patients with FH. We examined 225 patients with FH (126 males; mean age, 51 ± 18 years) who underwent carotid ultrasonography. We assessed baseline characteristics including lipid levels, other traditional risk factors, and the presence of coronary artery disease (CAD) as well as mean cIMT and cPS. Multivariate logistic analysis revealed that cPS was significantly associated with CAD (odds ratio [OR] 1.22, 95% confidence interval (CI) 1.10–1.37, p = 0.00036), whereas cIMT was not (OR 1.26, 95% CI 0.15 to 11.76, p = 0.84). Adding cPS information to other traditional risk factors improved the risk discrimination of CAD (C-index 0.887 vs 0.909, p = 0.030), whereas adding cIMT information did not (C-index 0.887 vs 0.893, p = 0.33). Regression equations were Y = 0.219X − 3.74 (r = 0.65, p