The University of Southampton
University of Southampton Institutional Repository

Combining carotid intima-media thickness with carotid plaque on screening for coronary heart disease

Combining carotid intima-media thickness with carotid plaque on screening for coronary heart disease
Combining carotid intima-media thickness with carotid plaque on screening for coronary heart disease
BACKGROUND: Ultrasound-detected carotid artery intima-media thickness (IMT) and carotid plaque are possible screening tests for coronary heart disease (CHD) among asymptomatic individuals.

OBJECTIVE: To assess the increase in screening performance of combining carotid IMT and plaque compared with each measurement alone in the identification of individuals with CHD.

METHODS: Ultrasound examination of left and right carotid arteries was performed on 100 individuals (median age 57), 55 with a history of CHD (unstable angina or myocardial infarction) and 45 without. IMT measurements were taken from the common carotid artery and plaque was identified above, at and below the carotid bifurcation. Associations between IMT and plaque were determined using logistic regression, and screening performance was assessed from the distributions of IMT and plaque among cases and controls.

RESULTS: At a false-positive rate of 5%, IMT (cut-off >0.75 mm) identified 30% (95% CI 14-58) of affected individuals. There was an increase in the detection rate of 8 percentage points (1-33%) using IMT and plaque combined compared with IMT alone. As the false-positive increased, the difference in the detection rate increased, up to a maximum of 20 percentage points (5-38%) at a false-positive rate of 20%. The comparison of IMT and plaque combined with plaque alone could only be estimated for the false-positive rate observed using plaque alone (18%); at this point the detection rate was 72% for plaque and 75% for plaque and IMT combined, an increase of 3 percentage points (0-4%).

CONCLUSION: In screening for CHD, combining carotid IMT measurement with plaque assessment is better than using either measurement alone, but the improvement in discrimination is not sufficient to make carotid ultrasound screening for CHD worthwhile.
155-159
Wald, D.S.
660868c9-88aa-485f-94b7-3b04e9477018
Bestwick, J.P.
3e21b633-02aa-4551-a9ac-9d1eddd4475c
Morton, G.
985d6f2b-819b-4dc6-bb25-f2b5e2dc268c
Drummond, L.
64176bfa-af96-4179-8cf8-544737bb344e
Jenkins, N.
cfee563f-e305-4a34-9fdd-a77f1b9c2045
Khodabakhsh, P.
dd9101e0-552c-4ad5-a8c9-317ebe2eff45
Curzen, N.
70f3ea49-51b1-418f-8e56-8210aef1abf4
Wald, D.S.
660868c9-88aa-485f-94b7-3b04e9477018
Bestwick, J.P.
3e21b633-02aa-4551-a9ac-9d1eddd4475c
Morton, G.
985d6f2b-819b-4dc6-bb25-f2b5e2dc268c
Drummond, L.
64176bfa-af96-4179-8cf8-544737bb344e
Jenkins, N.
cfee563f-e305-4a34-9fdd-a77f1b9c2045
Khodabakhsh, P.
dd9101e0-552c-4ad5-a8c9-317ebe2eff45
Curzen, N.
70f3ea49-51b1-418f-8e56-8210aef1abf4

Wald, D.S., Bestwick, J.P., Morton, G., Drummond, L., Jenkins, N., Khodabakhsh, P. and Curzen, N. (2009) Combining carotid intima-media thickness with carotid plaque on screening for coronary heart disease. Journal of Medical Screening, 16 (3), 155-159. (doi:10.1258/jms.2009.009039). (PMID:19805757)

Record type: Article

Abstract

BACKGROUND: Ultrasound-detected carotid artery intima-media thickness (IMT) and carotid plaque are possible screening tests for coronary heart disease (CHD) among asymptomatic individuals.

OBJECTIVE: To assess the increase in screening performance of combining carotid IMT and plaque compared with each measurement alone in the identification of individuals with CHD.

METHODS: Ultrasound examination of left and right carotid arteries was performed on 100 individuals (median age 57), 55 with a history of CHD (unstable angina or myocardial infarction) and 45 without. IMT measurements were taken from the common carotid artery and plaque was identified above, at and below the carotid bifurcation. Associations between IMT and plaque were determined using logistic regression, and screening performance was assessed from the distributions of IMT and plaque among cases and controls.

RESULTS: At a false-positive rate of 5%, IMT (cut-off >0.75 mm) identified 30% (95% CI 14-58) of affected individuals. There was an increase in the detection rate of 8 percentage points (1-33%) using IMT and plaque combined compared with IMT alone. As the false-positive increased, the difference in the detection rate increased, up to a maximum of 20 percentage points (5-38%) at a false-positive rate of 20%. The comparison of IMT and plaque combined with plaque alone could only be estimated for the false-positive rate observed using plaque alone (18%); at this point the detection rate was 72% for plaque and 75% for plaque and IMT combined, an increase of 3 percentage points (0-4%).

CONCLUSION: In screening for CHD, combining carotid IMT measurement with plaque assessment is better than using either measurement alone, but the improvement in discrimination is not sufficient to make carotid ultrasound screening for CHD worthwhile.

This record has no associated files available for download.

More information

Published date: 2009
Organisations: Human Development & Health

Identifiers

Local EPrints ID: 353102
URI: http://eprints.soton.ac.uk/id/eprint/353102
PURE UUID: 617bf508-f008-44f3-be89-fe69454e2a81
ORCID for N. Curzen: ORCID iD orcid.org/0000-0001-9651-7829

Catalogue record

Date deposited: 29 May 2013 13:19
Last modified: 15 Mar 2024 03:23

Export record

Altmetrics

Contributors

Author: D.S. Wald
Author: J.P. Bestwick
Author: G. Morton
Author: L. Drummond
Author: N. Jenkins
Author: P. Khodabakhsh
Author: N. Curzen ORCID iD

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×