Unravelling the Role of Carotid Atherosclerosis in Predicting Cardiovascular Disease Risk: A Review

Overview

Journal ARYA Atheroscler

Date 2024 Dec 24

PMID 39717161

Authors

Sidhi Laksono

Hillary Kusharsamita

Affiliations

Soon will be listed here.

Abstract

Carotid atherosclerosis disease assessment can predict the patient's risk of cardiovascular disease (CVD). The purpose of this review is to provide a comprehensive review of carotid atherosclerosis disease's pathophysiology, diagnostic evaluation, imaging applications, and treatment strategies. Carotid atherosclerosis is diagnosed using a variety of techniques, including transcranial Doppler imaging (TCD), computed tomography angiography (CTA), magnetic resonance angiography (MRA), and cerebral digital subtraction angiography (DSA), with duplex ultrasound (DUS) as the primary screening. Measurements of carotid intima-media thickness (CIMT) have drawn attention recently as a marker of early-stage carotid atherosclerosis or CVD risk prediction. The classification of cardiovascular risk may be enhanced by the expanding fields of stress testing and carotid plaque screening.

Citing Articles

Editorial: Reviews in cardiovascular pharmacology: 2023.

Kamisah Y, Laher I, Syamsunarno M Front Pharmacol. 2025; 16:1566159.

PMID: 40028161 PMC: 11868273. DOI: 10.3389/fphar.2025.1566159.

References

van Dam-Nolen D, van Egmond N, Dilba K, Nies K, van der Kolk A, Liem M . Sex Differences in Plaque Composition and Morphology Among Symptomatic Patients With Mild-to-Moderate Carotid Artery Stenosis. Stroke. 2022; 53(2):370-378. PMC: 8785521. DOI: 10.1161/STROKEAHA.121.036564. View

Piepoli M, Hoes A, Agewall S, Albus C, Brotons C, Catapano A . 2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by.... Eur Heart J. 2016; 37(29):2315-2381. PMC: 4986030. DOI: 10.1093/eurheartj/ehw106. View

Adams R, Chimowitz M, Alpert J, Awad I, Cerqueria M, Fayad P . Coronary risk evaluation in patients with transient ischemic attack and ischemic stroke: a scientific statement for healthcare professionals from the Stroke Council and the Council on Clinical Cardiology of the American Heart Association/American.... Circulation. 2003; 108(10):1278-90. DOI: 10.1161/01.CIR.0000090444.87006.CF. View

Tardif J, Heinonen T, Orloff D, Libby P . Vascular biomarkers and surrogates in cardiovascular disease. Circulation. 2006; 113(25):2936-42. DOI: 10.1161/CIRCULATIONAHA.105.598987. View

Enomoto Y, Yoshimura S, Yamada K, Kawasaki M, Nishigaki K, Minatoguchi S . Silent coronary artery disease in Japanese patients undergoing carotid artery stenting. J Stroke Cerebrovasc Dis. 2013; 22(7):1163-8. DOI: 10.1016/j.jstrokecerebrovasdis.2012.12.013. View

Baigent C, Keech A, Kearney P, Blackwell L, Buck G, Pollicino C . Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins. Lancet. 2005; 366(9493):1267-78. DOI: 10.1016/S0140-6736(05)67394-1. View

Hingwala D, Kesavadas C, Sylaja P, Thomas B, Kapilamoorthy T . Multimodality imaging of carotid atherosclerotic plaque: Going beyond stenosis. Indian J Radiol Imaging. 2013; 23(1):26-34. PMC: 3737614. DOI: 10.4103/0971-3026.113616. View

Wardlaw J, Chappell F, Stevenson M, De Nigris E, Thomas S, Gillard J . Accurate, practical and cost-effective assessment of carotid stenosis in the UK. Health Technol Assess. 2006; 10(30):iii-iv, ix-x, 1-182. DOI: 10.3310/hta10300. View

Ahmadvazir S, Shah B, Zacharias K, Senior R . Incremental Prognostic Value of Stress Echocardiography With Carotid Ultrasound for Suspected CAD. JACC Cardiovasc Imaging. 2017; 11(2 Pt 1):173-180. DOI: 10.1016/j.jcmg.2016.12.020. View

10.

Ahmadvazir S, Zacharias K, Shah B, Pabla J, Senior R . Role of simultaneous carotid ultrasound in patients undergoing stress echocardiography for assessment of chest pain with no previous history of coronary artery disease. Am Heart J. 2014; 168(2):229-36. DOI: 10.1016/j.ahj.2014.04.016. View

11.

STARY H, Chandler A, Dinsmore R, Fuster V, Glagov S, INSULL Jr W . A definition of advanced types of atherosclerotic lesions and a histological classification of atherosclerosis. A report from the Committee on Vascular Lesions of the Council on Arteriosclerosis, American Heart Association. Circulation. 1995; 92(5):1355-74. DOI: 10.1161/01.cir.92.5.1355. View

12.

Narins C, Illig K . Patient selection for carotid stenting versus endarterectomy: a systematic review. J Vasc Surg. 2006; 44(3):661-72. DOI: 10.1016/j.jvs.2006.05.042. View

13.

Hoffmann U, Ferencik M, Udelson J, Picard M, Truong Q, Patel M . Prognostic Value of Noninvasive Cardiovascular Testing in Patients With Stable Chest Pain: Insights From the PROMISE Trial (Prospective Multicenter Imaging Study for Evaluation of Chest Pain). Circulation. 2017; 135(24):2320-2332. PMC: 5946057. DOI: 10.1161/CIRCULATIONAHA.116.024360. View

14.

Saam T, Cai J, Ma L, Cai Y, Ferguson M, Polissar N . Comparison of symptomatic and asymptomatic atherosclerotic carotid plaque features with in vivo MR imaging. Radiology. 2006; 240(2):464-72. PMC: 1797417. DOI: 10.1148/radiol.2402050390. View

15.

Hartley C, Cole J . An ultrasonic pulsed Doppler system for measuring blood flow in small vessels. J Appl Physiol. 1974; 37(4):626-9. DOI: 10.1152/jappl.1974.37.4.626. View

16.

Bytyci I, Shenouda R, Wester P, Henein M . Carotid Atherosclerosis in Predicting Coronary Artery Disease: A Systematic Review and Meta-Analysis. Arterioscler Thromb Vasc Biol. 2021; 41(4):e224-e237. DOI: 10.1161/ATVBAHA.120.315747. View

17.

Netuka D, Belsan T, Broulikova K, Mandys V, Charvat F, Malik J . Detection of carotid artery stenosis using histological specimens: a comparison of CT angiography, magnetic resonance angiography, digital subtraction angiography and Doppler ultrasonography. Acta Neurochir (Wien). 2016; 158(8):1505-14. DOI: 10.1007/s00701-016-2842-0. View

18.

Shaalan W, Cheng H, Gewertz B, McKinsey J, Schwartz L, Katz D . Degree of carotid plaque calcification in relation to symptomatic outcome and plaque inflammation. J Vasc Surg. 2004; 40(2):262-9. DOI: 10.1016/j.jvs.2004.04.025. View

19.

Naqvi T, Lee M . Carotid intima-media thickness and plaque in cardiovascular risk assessment. JACC Cardiovasc Imaging. 2014; 7(10):1025-38. DOI: 10.1016/j.jcmg.2013.11.014. View

20.

Caetano Dos Santos F, Joutsen A, Paci M, Salenius J, Eskola H . Automatic detection of carotid arteries in computed tomography angiography: a proof of concept protocol. Int J Cardiovasc Imaging. 2016; 32(8):1299-310. DOI: 10.1007/s10554-016-0880-6. View