Low risk for heart attack? Could an ultrasound hold the answer?

Nov 11, 2008

By adding the results of an imaging technique to the traditional risk factors for coronary heart disease, doctors at Baylor College of Medicine in Houston found they were able to improve prediction of heart attacks in people previously considered low risk.

The findings are being presented today at the American Heart Association's Scientific Sessions in New Orleans.

Researchers used ultrasound imaging to view the carotid intima media thickness (C-IMT), or thickness of the artery walls.

"The ultrasound added another dimension to the risk factor score and showed us that those with thick arteries in the higher end of low risk group actually are at intermediate risk for coronary heart disease," said Dr. Vijay Nambi, assistant professor of medicine - atherosclerosis and vascular medicine at BCM and lead author of the study.

Risk prediction is traditionally divided into three groups: low, intermediate and high risk. Low risk is defined as having a less than a 10 percent chance of having coronary heart disease in the next 10 years. Intermediate is a 10 percent to 20 percent chance of a coronary event, and high risk is anything greater than 20 percent. This percentage is calculated by doctors using a score based on traditional risk factors which include age, gender, HDL cholesterol (good cholesterol), total cholesterol, hypertension and smoking.

Nambi and his colleagues followed more than 13,000 people already taking part in the Atherosclerosis Risk in Communities study, a large scale study designed to investigate the etiology and natural history of atherosclerosis. Participants in the current study were followed for almost 14 years. After adding imaging to the traditional risk factors, those in the higher end of the low risk group (estimated 10-year risk of 5 percent to 10 percent) were found to have a greater chance of having a heart attack especially if imaging revealed them to have a thicker C-IMT. Nambi said that about 4 percent of those who fell in the zero percent to 5 percent estimated risk had a heart attack, while more than 13 percent of those in the 5 percent to 10 percent suffered from coronary heart events. Furthermore, he pointed out that in the 5 percent to 10 percent risk group, those with the thickest arteries had approximately a 17 percent risk for coronary heart events when followed for 14 years.

"There is a big difference between 4 percent and 13 percent," said Nambi. "These results show us that we need to take a closer look at some of those individuals in the low risk category and even reconsider the definition of "low risk."

"Our goal is to target those in the most need," said Dr. Christie Ballantyne, chief of atherosclerosis and vascular medicine and professor of medicine at BCM. "Being able to pinpoint those more likely to have a heart attack will allow us to take early, more effective preventive action to stop a heart attack before it happens."

Source: Baylor College of Medicine

Explore further: Evidence-based recs issued for systemic care in psoriasis

add to favorites email to friend print save as pdf

Related Stories

Los Angeles proposes sweeping upgrades for quakes (Update)

Dec 08, 2014

Mayor Eric Garcetti on Monday proposed spending billions of dollars to better protect Los Angeles against a devastating earthquake by strengthening thousands of vulnerable older buildings and fortifying the city's water and ...

US village is cell phone free and loving it

Nov 13, 2014

In this rural speck of hyper-connected America, it's easier to hear a cow moo than a cell phone ring. That's because Green Bank is home to the world's most sensitive radio telescope, a device that catches the birth and death ...

Coming up for air

Oct 29, 2014

Sometimes you've got to hit bottom to battle your way back up. In 1992, the United Nations cited Mexico City as having the worst air quality in the world, with so much pollution that birds sometimes dropped ...

Recommended for you

Liberia holds Senate vote amid Ebola fears

4 hours ago

Health workers manned polling stations across Liberia on Saturday as voters cast their ballots in a twice-delayed Senate vote that has been criticized for its potential to spread the deadly Ebola disease.

Evidence-based recs issued for systemic care in psoriasis

Dec 19, 2014

(HealthDay)—For appropriately selected patients with psoriasis, combining biologics with other systemic treatments, including phototherapy, oral medications, or other biologic, may result in greater efficacy ...

Bacteria in caramel apples kills at least four in US

Dec 19, 2014

A listeria outbreak believed to originate from commercially packaged caramel apples has killed at least four people in the United States and sickened 28 people since November, officials said Friday.

Steroid-based treatment may answer needs of pediatric EoE patients

Dec 19, 2014

A new formulation of oral budesonide suspension, a steroid-based treatment, is safe and effective in treating pediatric patients with eosinophilic esophagitis (EoE), according to a new study in Clinical Gastroenterology and Hepatology, the official clinical practice journal ...

Discovery of genes that predispose a severe form of COPD

Dec 19, 2014

A study by Ramcés Falfán-Valencia, researcher at the National Institute of Respiratory Diseases (INER), found that the mestizo Mexican population has a number of variations in certain genes that predispose ...

User comments : 0

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.