Three-dimensional carotid ultrasound plaque texture predicts vascular events

TY - JOUR

T1 - Three-dimensional carotid ultrasound plaque texture predicts vascular events

AU - van Engelen, Arna

AU - Wannarong, Thapat

AU - Parraga, Grace

AU - Niessen, Wiro J.

AU - Fenster, Aaron

AU - Spence, J. David

AU - de Bruijne, Marleen

N1 - © 2014 American Heart Association, Inc.

PY - 2014/9/1

Y1 - 2014/9/1

N2 - BACKGROUND AND PURPOSE: Carotid ultrasound atherosclerosis measurements, including those of the arterial wall and plaque, provide a way to monitor patients at risk of vascular events. Our objective was to examine carotid ultrasound plaque texture measurements and the change in carotid plaque texture during 1 year in patients at risk of events and to compare these with measurements of plaque volume and other risk factors as predictors of vascular events.METHODS: We evaluated 298 patients with carotid atherosclerosis using 3-dimensional (3D) ultrasound at baseline and after 1 year and measured carotid plaque volume and 376 measures of plaque texture. Patients were followed up to 5 years (median [range], 3.12 [0.77-4.66]) for myocardial infarction, transient ischemic attack, and stroke. Sparse Cox regression was used to select the most predictive plaque texture measurements in independent training sets using a 10-fold cross-validation, repeated 5×, to ensure unbiased results.RESULTS: Receiver operator curves and Kaplan-Meier analysis showed that changes in texture and total plaque volume combined provided the best predictor of vascular events. In multivariate Cox regression, changes in plaque texture (median hazard ratio, 1.4; P<0.001) and total plaque volume (median hazard ratio, 1.5 per 100 mm(3); P<0.001) were both significant predictors, whereas the Framingham risk score was not.CONCLUSIONS: Changes in both plaque texture and volume are strongly predictive of vascular events. In high-risk patients, 3D ultrasound plaque measurements should be considered for vascular event risk prediction.

AB - BACKGROUND AND PURPOSE: Carotid ultrasound atherosclerosis measurements, including those of the arterial wall and plaque, provide a way to monitor patients at risk of vascular events. Our objective was to examine carotid ultrasound plaque texture measurements and the change in carotid plaque texture during 1 year in patients at risk of events and to compare these with measurements of plaque volume and other risk factors as predictors of vascular events.METHODS: We evaluated 298 patients with carotid atherosclerosis using 3-dimensional (3D) ultrasound at baseline and after 1 year and measured carotid plaque volume and 376 measures of plaque texture. Patients were followed up to 5 years (median [range], 3.12 [0.77-4.66]) for myocardial infarction, transient ischemic attack, and stroke. Sparse Cox regression was used to select the most predictive plaque texture measurements in independent training sets using a 10-fold cross-validation, repeated 5×, to ensure unbiased results.RESULTS: Receiver operator curves and Kaplan-Meier analysis showed that changes in texture and total plaque volume combined provided the best predictor of vascular events. In multivariate Cox regression, changes in plaque texture (median hazard ratio, 1.4; P<0.001) and total plaque volume (median hazard ratio, 1.5 per 100 mm(3); P<0.001) were both significant predictors, whereas the Framingham risk score was not.CONCLUSIONS: Changes in both plaque texture and volume are strongly predictive of vascular events. In high-risk patients, 3D ultrasound plaque measurements should be considered for vascular event risk prediction.

U2 - 10.1161/strokeaha.114.005752

DO - 10.1161/strokeaha.114.005752

M3 - Journal article

C2 - 25034714

SN - 0039-2499

VL - 45

SP - 2695

EP - 2701

JO - Stroke

JF - Stroke

ER -