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The Atherosclerosis Burden Score (ABS): a Convenient Ultrasound-Based Score of Peripheral Atherosclerosis for Coronary Artery Disease Prediction

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Abstract

Ultrasonographic detection of subclinical atherosclerosis improves cardiovascular risk stratification, but uncertainty persists about the most discriminative method to apply. In this study, we found that the “atherosclerosis burden score (ABS)”, a novel straightforward ultrasonographic score that sums the number of carotid and femoral arterial bifurcations with plaques, significantly outperformed common carotid intima-media thickness, carotid mean/maximal thickness, and carotid/femoral plaque scores for the detection of coronary artery disease (CAD) (receiver operating characteristic (ROC) curve area under the curve (AUC) = 0.79; P = 0.027 to <0.001 with the other five US endpoints) in 203 patients undergoing coronary angiography. ABS was also more correlated with CAD extension (R = 0.55; P < 0.001). Furthermore, in a second group of 1128 patients without cardiovascular disease, ABS was weakly correlated with the European Society of Cardiology chart risk categories (R 2 = 0.21), indicating that ABS provided information beyond usual cardiovascular risk factor-based risk stratification. Pending prospective studies on hard cardiovascular endpoints, ABS appears as a promising tool in primary prevention.

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Abbreviations

ABS:

Atherosclerosis burden score

ATS:

Atherosclerosis

CAD:

Coronary artery disease

CV:

Cardiovascular

C-IMT:

Carotid intima-media thickness

ESC:

European Society of Cardiology

IMT:

Intima-media thickness

RF:

Risk factors

US:

Ultrasound

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Acknowledgments

The authors wish to thank Prof. Vincent Mooser for his helpful remarks and suggestions about this study as well as for his critical reviewing of the manuscript.

Funding

This study was supported by grants from the Swiss Heart Foundation (CH-3000 Bern, Switzerland) and the Michel Tossizza Foundation (CH-1000 Lausanne, Switzerland).

Conflict of Interest

No conflict of interest exists for any of the authors.

Human Subjects/Informed Consent Statement

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.

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    Authors and Affiliations

    1. Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland

      Patrick Yerly, Reza Owlya, Eric Eeckhout & Lukas Kappenberger

    2. Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland

      Pedro Marquès-Vidal

    3. Consultation for Lipid and Cardiovascular Prevention, Department of Ambulatory and Community Medicine, Lausanne University Hospital, Lausanne, Switzerland

      Roger Darioli

    4. Department of Angiology, Lausanne University Hospital, Lausanne, Switzerland

      Michèle Depairon

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    1. Patrick Yerly
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    2. Pedro Marquès-Vidal
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    Correspondence to Patrick Yerly.

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    Associate Editor Emanuele Barbato oversaw the review of this article

    Roger Darioli and Michèle Depairon contributed equally to this work.

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    Yerly, P., Marquès-Vidal, P., Owlya, R. et al. The Atherosclerosis Burden Score (ABS): a Convenient Ultrasound-Based Score of Peripheral Atherosclerosis for Coronary Artery Disease Prediction. J. of Cardiovasc. Trans. Res. 8, 138–147 (2015). https://doi.org/10.1007/s12265-015-9617-5

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