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Neck Artery Ultrasound IDs Heart Risk

Imaging of Carotid Artery May Help Reveal Risk for Heart Attack and Stroke
By
WebMD Health News
Reviewed by Louise Chang, MD

May 8, 2006 -- Many middle-aged people who suffer heart attacks and strokes have few risk factors for heart diseaseheart disease or strokestroke. Now new research suggests that a simple ultrasound test could help doctors tell the difference between patients who really do have a low risk for cardiovascular events and those who just seem to.

Ultrasound imaging of the carotid neck artery proved remarkably effective for identifying seemingly low-risk patients who actually had cause for concern.

Nine out of 10 middle-aged study participants who had a cardiovascular event during the two-and-a-half year study showed early evidence of plaque buildup, or atherosclerosis, in the carotid arteries of the neck on the ultrasound.

Results from the study were presented Monday at the American Heart Association's 7th Scientific Forum on Quality of Care, held in Washington D.C.

Plaque Buildup

"The most significant finding was that only one of the people who had a negative scan had an event within the next few years," researcher Kwame O. Akosah, MD, tells WebMD.

Akosah, the director of the Heart FailureHeart Failure Clinic at Gunderson Lutheran Health Systems in La Crosse, Wis., says that the imaging procedure could prove to be an important addition to current screening measures.

Atherosclerosis occurs when fatty deposits and other substances, known as plaque, build up in the arteries. This buildup can raise risk for both heart attackheart attack and stroke.

Plaque buildup in a carotid neck artery is a signal that other important arteries may have the buildup as well; earlier studies suggested that ultrasound imaging of the neck artery could help predict cardiovascular risk.

Test Predicted Events

In the latest study, Akosah and colleagues at Gunderson and the University of Wisconsin performed the ultrasound imaging on 246 people. The average age of the males in the study was 55 and the average age of the females was 65.

All of the study subjects were considered to have a low overall risk for heart diseaseheart disease, meaning that they had relatively normal blood pressure and cholesterol, did not smoke, and had no other major cardiovascular risk factors, Akosah says. Those with a known history of coronary heart disease or who were taking medication for high cholesterolhigh cholesterol were not included in the study.

When the ultrasound was performed, 149 study participants showed evidence of carotid artery plaque buildup, while the rest did not.

The subjects were followed for about 32 months following ultrasound testing. During this follow-up, the people who had the abnormal tests were nearly three times more likely than those without plaque buildup in the neck artery to develop severe coronary artery blockage.

Of the 10 people in the study who either died or suffered from heart attacks or strokes, nine had evidence of noncardiac atherosclerosis on the earlier ultrasound.

And 27 of the 36 participants, including the previously mentioned 10 people and others who underwent cardiovascular procedures such as heart bypass surgery or angioplasty -- or who were diagnosed with heart failureheart failure -- also showed evidence of plaque buildup in their neck's carotid arteries on the earlier ultrasound.

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