One of the imaging tests most commonly used to assess cardiovascular diseases (CVDs) in daily practice is Doppler ultrasonography of the carotid and femoral arteries. We included 2709 participants with no history or symptoms of CVD; they had a risk factor assessment and a carotid and femoral ultrasonography at baseline. Incident cases of definite coronary events were recorded during a median follow-up of 6 years. Approximately, 63% of the sample presented abnormalities (carotid stenosis >50%, carotid plaque, femoral plaque, increased intima–media thickness [IMT]). A moderately increased IMT (>0.63 mm) or the presence of carotid or femoral artery plaque was related to prognosis. The associations persisted after adjustment for pretest risk, treatment with statins, and other Doppler ultrasonography abnormalities. The hazard ratio increased significantly with the number of abnormalities (varying from 2.35 [1.16-4.74] to 14.83 [6.47-33.9]).
AndersonKMWilsonPWOdellPMKannelWB. An updated coronary risk profile. A statement for health professionals. Circulation. 1991;83(1):356–362.
2.
ConroyRMPyoralaKFitzgeraldAP. Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project. Eur Heart J. 2003;24(11):987–1003.
3.
PearsonTA. New tools for coronary risk assessment: what are their advantages and limitations?Circulation. 2002;105(7):886–892.
4.
FerrieresJEliasARuidavetsJB. Carotid intima-media thickness and coronary heart disease risk factors in a low-risk population. J Hypertens. 1999;17(6):743–748.
5.
ChamblessLEHeissGFolsomAR. Association of coronary heart disease incidence with carotid arterial wall thickness and major risk factors: the Atherosclerosis Risk in Communities (ARIC) Study, 1987-1993. Am J Epidemiol. 1997;146(6):483–494.
6.
SalonenJTSalonenR. Ultrasonographically assessed carotid morphology and the risk of coronary heart disease. Arterioscler Thromb. 1991;11(5):1245–1249.
7.
HondaOSugiyamaSKugiyamaK. Echolucent carotid plaques predict future coronary events in patients with coronary artery disease. J Am Coll Cardiol. 2004;43(7):1177–1184.
8.
BelcaroGNicolaidesANRamaswamiG. Carotid and femoral ultrasound morphology screening and cardiovascular events in low risk subjects: a 10-year follow-up study (the CAFES-CAVE study(1)). Atherosclerosis. 2001;156(2):379–387.
9.
CournotMBoccalonHCambouJP. Accuracy of the screening physical examination to identify subclinical atherosclerosis and peripheral arterial disease in asymptomatic subjects. J Vasc Surg. 2007;46(6):1215–1221.
10.
CournotMTaraszkiewiczDCambouJP. Additional prognostic value of physical examination, exercise testing, and arterial ultrasonography for coronary risk assessment in primary prevention. Am Heart J. 2009;158(5):845–851.
11.
Marques-VidalPRuidavetsJBAmouyelP. Change in cardiovascular risk factors in France, 1985-1997. Eur J Epidemiol. 2004;19(1):25–32.
12.
Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation. 2002;106(25):3143–3421.
13.
AndersonKMWilsonPWOdellPMKannelWB. An updated coronary risk profile. A statement for health professionals. Circulation. 1991;83(1):356–362.
14.
NicolaidesAShifrinEBradburyA. Angiographic and duplex grading of internal carotid stenosis: can we overcome the confusion?J Endovasc Surg. 1996;3(2):158–165.
15.
DucimetierePRuidavetsJBMontayeMHaasBYarnellJ. Five-year incidence of angina pectoris and other forms of coronary heart disease in healthy men aged 50-59 in France and Northern Ireland: the Prospective Epidemiological Study of Myocardial Infarction (PRIME) Study. Int J Epidemiol. 2001;30(5):1057–1062.
16.
GariepyJSalomonJDenarieN. Sex and topographic differences in associations between large-artery wall thickness and coronary risk profile in a French working cohort: the AXA Study. Arterioscler Thromb Vasc Biol. 1998;18(4):584–590.
17.
DenarieNGariepyJChironiG. Distribution of ultrasonographically-assessed dimensions of common carotid arteries in healthy adults of both sexes. Atherosclerosis. 2000;148(2):297–302.
18.
DepaironMTuttaPvan MelleGHayozDKappenbergerLDarioliR. [Reference values of intima-medial thickness of carotid and femoral arteries in subjects aged 20 to 60 years and without cardiovascular risk factors]. Arch Mal Coeur Vaiss. 2000;93(6):721–726.
19.
WongMEdelsteinJWollmanJBondMG. Ultrasonic-pathological comparison of the human arterial wall. Verification of intima-media thickness. Arterioscler Thromb. 1993;13(4):482–486.
20.
O’LearyDHPolakJFKronmalRA. Distribution and correlates of sonographically detected carotid artery disease in the Cardiovascular Health Study. The CHS Collaborative Research Group. Stroke. 1992;23(12):1752–1760.
21.
BotsMLHoesAWKoudstaalPJHofmanAGrobbeeDE. Common carotid intima-media thickness and risk of stroke and myocardial infarction: the Rotterdam Study. Circulation. 1997;96(5):1432–1437.
22.
PenckoferSFilliungDRLabropoulosN. Non-invasive cardiovascular risk assessment in women with type 2 diabetes. J Vasc Nurs. 2005;23(1):2–7.
23.
WoffordJLKahlFRHowardGRMcKinneyWMTooleJFCrouseJR3rd. Relation of extent of extracranial carotid artery atherosclerosis as measured by B-mode ultrasound to the extent of coronary atherosclerosis. Arterioscler Thromb. 1991;11(6):1786–1794.
24.
TouboulPJLabreucheJVicautEAmarencoP. Carotid intima-media thickness, plaques, and Framingham risk score as independent determinants of stroke risk. Stroke. 2005;36(8):1741–1745.
25.
AboyansVLacroixPPostilA. Subclinical peripheral arterial disease and incompressible ankle arteries are both long-term prognostic factors in patients undergoing coronary artery bypass grafting. J Am Coll Cardiol. 2005;46(5):815–820.
26.
AminbakhshAManciniGB. Carotid intima-media thickness measurements: what defines an abnormality? A systematic review. Clin Invest Med. 1999;22(4):149–157.
27.
Kablak-ZiembickaATraczWPrzewlockiTPieniazekPSokolowskiAKonieczynskaM. Association of increased carotid intima-media thickness with the extent of coronary artery disease. Heart. 2004;90(11):1286–1290.
28.
HollanderMHakAEKoudstaalPJ. Comparison between measures of atherosclerosis and risk of stroke: the Rotterdam Study. Stroke. 2003;34(10):2367–2372.
29.
CuiRKitamuraAYamagishiK. Ankle-arm blood pressure index as a correlate of preclinical carotid atherosclerosis in elderly Japanese men. Atherosclerosis. 2006;184(2):420–424.
30.
MathiesenEBBonaaKHJoakimsenO. Echolucent plaques are associated with high risk of ischemic cerebrovascular events in carotid stenosis: the Tromso study. Circulation. 2001;103(17):2171–2175.
31.
IwamotoTJingziJSugiyamaTUmaharaTTakasakiM. Prognosis of the elderly with asymptomatic atherosclerotic plaques of the carotid arteries. Intern Med. 2002;41(7):526–531.
32.
NossenJMVierzigmannTLangE. [Calcified plaques of extracranial carotid arteries and left ventricular geometry as predictors of coronary artery disease]. Med Klin (Munich). 2003;98(2):72–78.
33.
JoakimsenOBonaaKHMathiesenEBStensland-BuggeEArnesenE. Prediction of mortality by ultrasound screening of a general population for carotid stenosis: the Tromso Study. Stroke. 2000;31(8):1871–1876.
34.
OgrenMHedbladBIsacssonSOJanzonLJungquistGLindellSE. Ten year cerebrovascular morbidity and mortality in 68 year old men with asymptomatic carotid stenosis. BMJ. 1995;310(6990):1294–1298.
35.
NadareishviliZGRothwellPMBeletskyVPagnielloANorrisJW. Long-term risk of stroke and other vascular events in patients with asymptomatic carotid artery stenosis. Arch Neurol. 2002;59(7):1162–1166.
36.
PujiaARubbaPSpencerMP. Prevalence of extracranial carotid artery disease detectable by echo-Doppler in an elderly population. Stroke. 1992;23(6):818–822.
37.
WilsonPWHoegJMD’AgostinoRB. Cumulative effects of high cholesterol levels, high blood pressure, and cigarette smoking on carotid stenosis. N Engl J Med. 1997;337(8):516–522.
38.
O’RiordainDSO’DonnellJA. Realistic expectations for the patient with intermittent claudication. Br J Surg. 1991;78(7):861–863.
39.
KuulasmaaKTunstall-PedoeHDobsonA. Estimation of contribution of changes in classic risk factors to trends in coronary-event rates across the WHO MONICA Project populations. Lancet. 2000;355(9205):675–687.
40.
BruceRADeRouenTAHossackKF. Pilot study examining the motivational effects of maximal exercise testing to modify risk factors and health habits. Cardiology. 1980;66(2):111–119.
