CAROTID ARTERY PLAQUE PROGRESSION: PROPOSAL OF A NEW PREDICTIVE SCORE AND ROLE OF CAROTID INTIMA-MEDIA THICKNESS (ID 798)

Presentation Topic
AS20 LARGE ARTERY ATHEROSCLEROSIS - INCLUDING INTRACRANIAL STENOSIS
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nicoletta.brunelli@gmail.com

Abstract

Background And Aims

Longitudinal changes in carotid intima-media thickness (IMT) and plaque are considered markers of atherosclerosis progression and predictors of cardio and cerebrovascular events. However, a clinical predictive risk score of plaque progression is currently lacking. We aimed to investigate if a new proposed risk score (HAD2S score) composed by the sum of single vascular risk factors (Hypertension, Age ≥ 75 years, Diabetes, Dyslipidemia and Smoking) and baseline IMT were predictive of plaque progression.

Methods

We performed a retrospective analysis on real-life prospectively collected data. We include all patients with any detectable carotid plaque. The plaque score was defined as 0: no plaque or stenosis <30%; 1: stenosis between 30-49%; 2: stenosis between 50-69%; 3: stenosis between 70-99% and 4: occlusion. Vascular risk factors, stenosis progression, IMT, Peak Systolic Velocity and End Diastolic Velocity were investigated in all patients at baseline and at a median follow-up of 36.6 months (IQR 39.6-34.3). HAD2S score was calculated for all patients.

Results

The 340 included patients were aged 69.9 (9.1) years (52% men). 25% of subjects had plaque progression. Mean IMT at baseline was associated with plaque progression (p<0.0001). Patients with progression had a mean IMT at baseline of 0.86 (0.17) while those who didn’t present progression had a mean IMT at baseline of 0.77 (0.18). The 87.2% of patients with plaque progression had a HAD2S score ≥ 2 (p=0.044).

Conclusions

Our data demonstrates that mean IMT at baseline and initial HAD2S score ≥ 2 could be considered predictors of plaque progression.

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