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Ultrasound Diagnosis of Carotid Artery Lesions in a Population of Asymptomatic Subjects Presenting Atherosclerosis Risk Factors

Abstract

Carotid artery atherosclerosis, age, family history, smoking, arterial hypertension, diabetes mellitus, and dyslipidemia represent risk factors of cerebrovascular events (stroke and transient ischemic attack). Hence, preventive treatment is vital for patients presenting these factors. Seven hundred and sixty-six patients (348 men and 418 women; age range 30-80 years) who were asymptomatic and attending a vascular unit for routine ultrasound (US) screening of the carotid arteries and with risk factors, intima-media thickness (IMT) of carotid artery > 1.3 mm, IMT associated with findings of atherosclerotic plaque creating stenosis > 20%, < or = 50%, and carotid plaque creating stenosis > 50% were considered. For patients with diabetes and hyperlipemia (35.8%)--or with hypertension, diabetes, and hyperlipemia (34.8%)--a higher prevalence of IMT > 1.3 mm was found. Higher prevalence of atherosclerotic plaque > 50% varied between 14.2% (in cases with diabetes mellitus and dyslipidemia) and 29.6% (in cases presenting 4 concomitant risk factors). Direct correlation was found between different risk factors and US findings. Our US findings revealed both a high incidence of carotid atherosclerosis, and that single and multiple correlation between US diagnosis of vascular damage and risk factors further enhanced risk. The study results confirmed the significance of vascular risk factors in patients with carotid artery atherosclerosis, and underlined the diagnostic validity of US.

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