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International Angiology 2021 December;40(6):470-7

DOI: 10.23736/S0392-9590.21.04637-X


language: English

Electrocardiographic abnormalities, preclinical carotid atherosclerosis and cardiovascular risk in an apparently healthy real-world population. Data from the “No Stroke, No Infarction” project of the Rotary International - district 2110 (Sicily and Malta)

Salvatore NOVO 1, 2, 3 , Davide DIANA 4, 5, Claudio TOMASINO 4, 5, Giulia ZAMBELLI 4, 5, Antonino MIGNANO 4, 5, Andrea SCALMATO 4, 5, Laura MANISCALCO 6, Alfredo R. GALASSI 4, 5, Domenica MATRANGA 4, Giuseppina NOVO 4, 5

1 School of Medicine, University of Palermo, Palermo, Italy; 2 Paolo Giaccone University Hospital, Palermo, Italy; 3 International School of Cardiology, Ettore Majorana Foundation and Center for Scientific Culture, Erice, Trapani, Italy; 4 Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy; 5 Intensive Coronary Care Unit, Emergency Department, Paolo Giaccone University Hospital, Palermo, Italy; 6 Department of Biomedicine, Neuroscience and Advanced Diagnostics (BIND), University of Palermo, Palermo, Italy

BACKGROUND: Cardiovascular diseases (CVDs) represent important causes of morbidity and mortality. Our study aimed to evaluate cardiovascular risk using the EuroSCORE, ECG and carotid ultrasound for prevention purpose in a population of companions aged 50-70 years, asymptomatic and without CVD.
METHODS: History of CVD, risk factors (RF), ECG and carotid ultrasound were evaluated. Intima-media thickness (IMT) was defined as wall thickness >0.9 mm, while focal thickening ≥1.5 mm protruding into the lumen as asymptomatic carotid plaque (ACP).
RESULTS: Totally, 1860 subjects were screened. 393 (21.1%) had no RF, 780 (42%) hypertension, 571 (30.7%) hypercholesterolemia, 557 (29.9%) diabetes, 474 (25.5%) smoking, 648 (34.8%) overweight, 300 (16.1%) obesity and 184 (9.9%) metabolic syndrome. Carotid atherosclerosis was detected in 903 (48.5%) subjects, 821 (44.1%) had IMT and 547 (29.4%) ACP, and was significantly related to diabetes, hypertension and hypercholesterolemia. Atrial fibrillation was found in 29 subjects (1.6%) and Brugada pattern in one. Using EuroSCORE, 220 subjects resulted at low (11.8%), 1338 at moderate (71.9%), 292 at high (15.7%) and 10 at very-high risk (0.5%). Adding ACP, the percentages were: low 159 (8.54%), moderate 1020 (54.83%), high 663 (35.64%) and very-high risk 18 (0.96%).
CONCLUSIONS: A total of 302 (16.2%) subjects were at least at high risk for CV events according to the EuroSCORE, increasing to 681 (36.61%; P<0.001) adding ACP. The combination of EuroSCORE with ECG may be a useful tool in primary prevention. Carotid ultrasound furtherly increases the power of stratification of asymptomatic patients suitable for pharmacological treatment.

KEY WORDS: Atherosclerosis; Heart disease risk factors; Stroke; Prevention and control; Carotid intima-media thickness

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