ORIGINAL ARTICLE  CAROTID DISEASE Free access

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

DOI: 10.23736/S0392-9590.21.04637-X

Copyright © 2021 EDIZIONI MINERVA MEDICA

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