Usefulness of Carotid Ultrasound Screening in Primary Cardiovascular Prevention: A Systematic Review.

Autor: Sebastian SA; Department of Internal Medicine, Azeezia Medical College, Kollam, Kerala, India. Electronic address: snehaann1991@gmail.com., Co EL; Department of Internal Medicine, University of Santo Tomas Faculty of Medicine and Surgery, Manila, Philippines., Tidd-Johnson A; Department of Medicine, American University of Antigua, Coolidge, Antigua., Chowdhury S; Department of Medicine, Dhaka Medical College, Dhaka, Bangladesh., Jain E; Department of Family Medicine, Cooper University Hospital, Camden, NJ, USA., Davidson M; Department of Medicine, Ross University School of Medicine, USA., Johal G; Department of Cardiology, University of Washington, Valley Medical Center, Seattle, USA.
Jazyk: angličtina
Zdroj: Current problems in cardiology [Curr Probl Cardiol] 2024 Jan; Vol. 49 (1 Pt C), pp. 102147. Date of Electronic Publication: 2023 Oct 19.
DOI: 10.1016/j.cpcardiol.2023.102147
Abstrakt: Background: Cardiovascular disease (CVD) is the leading cause of morbidity and mortality worldwide, and its prevention is more cost-effective than the treatment of its complications. Although cardiovascular (CV) risk assessment based on conventional risk factors is the general recommendation, a significant percentage of the population, irrespective of these risk factors, present with subclinical atherosclerosis during carotid Doppler ultrasound (US) imaging. Subclinical atherosclerotic lesions at the carotid bifurcations may be related to the incidence of future CV events and occult atherosclerotic coronary disease. Such patients might benefit from preventive measures if the carotid Doppler US is allowed as a screening tool to detect the extent of carotid stenosis. We aimed to conduct a comprehensive and systematic evaluation of the impact of carotid US screening on CV risk stratification.
Methods: We searched PubMed, Scopus, and ScienceDirect from inception until July 2023. We included literature that examined the impact of carotid US screening on cardiovascular risk factor (CVRF) prevention, CV events, and mortality in adults of all age groups free of symptomatic carotid artery disease.
Results: We identified 2 randomized controlled trials (RCTs) and 9 observational studies, including 21,046 participants. The mean age of the participants was 49, and 53% were female. Two RCTs, with 7,064 participants, examined the impact of pictorial knowledge about subclinical carotid atherosclerosis using carotid US versus traditional CVD risk evaluation without any US evidence in primary cardiovascular prevention. Both studies reported remarkable improvement in medication adherence at 1 to 3-year follow-up after carotid US screening with a decrease in Framingham risk score (FRS). Nine observational studies with 13, 982 participants analyzed the evidence of atherosclerosis on carotid US screening and demonstrated that it is a beneficial tool in the early identification of subclinical atherosclerosis and effective therapeutic intervention.
Conclusion: This systematic review found that pictorial presentation of silent atherosclerosis using carotid US screening has a contributory role in CV risk stratification and prevention of CVD.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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