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Intima-Media Thickness and Plaque Evaluation: Predictive Value of Cardiovascular Events and Contribution to Cardiovascular Risk Evaluation

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Noninvasive Vascular Diagnosis

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Abstract

Atherosclerosis prevention and its progression has become an important goal in medicine. Atherosclerotic disease is a long and silently evolving disease and hardly reversible when clinical events occur. New imaging biomarkers are useful if they can help in the early characterization of a population that is at intermediate risk, in order to detect vascular risk phenotypes and improve their management. Ultrasonography of the carotid arteries is safe, inexpensive, easy to perform, and a reliable and accurate method to detect early changes of increased thickening of the arterial wall and plaque occurrence. Intima-media thickness of the carotid artery (CIMT) and plaque are recognized biomarkers, they can improve our knowledge and practice in the field of cardiovascular risk evaluation and prevention.

From 1986 to nowadays, thousands of publications have demonstrated the potential of CIMT and carotid plaque evaluation to anticipate the risk of coronary and stroke events and to improve detection of cardiovascular risk factors by their significant association to hypertension, cholesterol, diabetes, and smoking.

If some recommendations are now published by American and European societies and standardization of the method is ready for use in clinical practice, we need more data on reference values in different countries to address for clinical use the best accuracy for cardiovascular risk evaluation in individuals. Framingham score may be poor for a large group of patients at intermediate risk and some at low risk. The combination of Framingham score and IMT and/or plaque evaluation may increase the power to prevent myocardial infarction and stroke as demonstrated by recent studies. Moreover, Framingham score only provides the cardiovascular risk at 10 years. This limit makes the comparison between a clinical score and an imaging biomarker more difficult. Large recent meta-analysis of more than 100,000 patients establishes the usefulness of cIMT progression as a surrogate marker for CVD risk in clinical trials.

On another end cIMT might be the imaging biomarker to improve personalized prevention, given its high correlation with traditional risk factors often neglected or missed in general practice.

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Author information

Authors and Affiliations

  1. INSERM U1148, Laboratory for Vascular Translation Science, Paris, France

    Pierre Jean Touboul

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  1. Pierre Jean Touboul
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Editor information

Editors and Affiliations

  1. Department of Surgery, West Virginia University, Charleston, WV, USA

    Ali F. AbuRahma

  2. Johns Hopkins University, Baltimore, USA

    Bruce A. Perler

Section Editor information

  1. Department of Surgery, Division of Vascular/Endovascular Surgery, West Virginia University - Charleston Division, Charleston, WV, USA

    Ali F. AbuRahma

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Touboul, P.J. (2021). Intima-Media Thickness and Plaque Evaluation: Predictive Value of Cardiovascular Events and Contribution to Cardiovascular Risk Evaluation. In: AbuRahma, A.F., Perler, B.A. (eds) Noninvasive Vascular Diagnosis. Springer, Cham. https://doi.org/10.1007/978-3-030-49616-6_12-1

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  • DOI: https://doi.org/10.1007/978-3-030-49616-6_12-1

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-49616-6

  • Online ISBN: 978-3-030-49616-6

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