Measurement of carotid intima-media thickness and carotid plaque detection for cardiovascular risk assessment

Carotid ultrasound for prediction of CVD risk has transitioned from a research tool to a clinical test that has now been addressed by eight guidelines and consensus statements. Individuals with increased CIMT and/or carotid plaque presence are at increased risk of adverse CVD events. There are well-described standards for performing and reporting these tests as well as for training, instrumentation, and appropriate patient selection.16 Observational data suggests that healthcare providers are very responsive to the results of these tests and are more likely to prescribe lipid-lowering therapy and aspirin to individuals with subclinical arterial disease identified by carotid ultrasonography; however, the effects of screening on patient behaviors are more complicated. Despite promising preliminary data, there is significant inconsistency in the existing but limited data regarding the effects of identifying subclinical arterial injury on patients' health-related behaviors. Randomized clinical trials are needed to determine if identifying subclinical vascular disease improves longterm patient outcomes. © 2010 American Society of Nuclear Cardiology.