Current cardiology reports
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Atherosclerosis is the underlying cause of most myocardial infarction (MI) and ischemic strokes. B-mode ultrasound of carotid arteries provides measures of intima-media thickness (IMT) and plaques, both widely used as surrogate measures of cardiovascular disease. Although IMT and plaques are highly intercorrelated, IMT's role as a marker of atherosclerosis has been questioned, especially when measurements include the common carotid artery (CCA) only. ⋯ Plaque measured in the carotid bulb or internal carotid artery is stronger related to hyperlipidemia and smoking and is a stronger predictor for MI, whereas CCA-IMT is stronger related to hypertension and ischemic stroke. Echolucent plaque morphology (ie, lipid-rich plaques) seems to increase the risk for MI and stroke. New evidence suggests that total plaque area is the most strongly predictive of cardiovascular risk of the ultrasound phenotypes.