Carotid Plaque Burden as a Measure of Subclinical Coronary Artery Disease in Patients With Heterozygous Familial Hypercholesterolemia

GL Kate, Gert-Jan Kate, Stijn Oord, Admir Dedic, Anoeshka Dharampal, Koen Nieman, Pim Feijter, E.J.G. Sijbrands, Ton van der Steen, Arend Schinkel

Research output: Contribution to journalArticleAcademicpeer-review

19 Citations (Scopus)

Abstract

Patients with familial hypercholesterolemia (FH) are at markedly increased risk of developing premature coronary artery disease. The objective of the present study was to evaluate the role of carotid ultrasonography as a measure of subclinical coronary artery disease in patients with FH. The present prospective study compared the presence of subclinical carotid and coronary artery disease in 67 patients with FH (mean age 55 8 years, 52% men) to that in 30 controls with nonanginal chest pain (mean age 56 +/- 9 years, 57% men). The carotid intima-media thickness and carotid plaque burden were assessed using B-mode ultrasonography, according to the Mannheim consensus. Coronary artery disease was assessed using computed tomographic coronary angiography. A lumen reduction >50% was considered indicative of obstructive coronary artery disease. The patients with FH and the controls had a comparable carotid intima-media thickness (0.64 vs 0.66 mm, p = 0.490), prevalence of carotid plaque (93% vs 83%, p = 0.361), and median carotid plaque score (3 vs 2, p = 0.216). Patients with FH had a significantly greater median coronary calcium score than did the controls (62 vs 5, p = 0.015). However, the prevalence of obstructive coronary artery disease was comparable (27% vs 31%, p = 0.677). No association was found between the carotid intima-media thickness and coronary artery disease. An association was found between the presence of carotid plaque and coronary artery disease in the patients with FH and the controls. The absence of carotid plaque, observed in 5 patients (7%) with FH, excluded the presence of obstructive coronary artery disease. In conclusion, the patients with FH had a high prevalence of carotid plaque and a significantly greater median coronary calcium score than did the controls. A correlation was found between carotid plaque and coronary artery disease in patients with FH; however, the presence of carotid plaque and carotid plaque burden are not reliable indicators of obstructive coronary artery disease. (C) 2013 Elsevier Inc. All rights reserved.
Original languageUndefined/Unknown
Pages (from-to)1305-1310
Number of pages6
JournalAmerican Journal of Cardiology
Volume111
Issue number9
DOIs
Publication statusPublished - 2013

Cite this