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International Angiology 2021 Jul 20

DOI: 10.23736/S0392-9590.21.04637-X

Copyright © 2021 EDIZIONI MINERVA MEDICA

lingua: Inglese

Electrocardiographic abnormalities, preclinical carotid atherosclerosis andcardiovascular risk, in an apparently healthy real-world population: data from the project “No Stroke, No Infarction” of the rotary international - District 2110 “Sicily &
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 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 G. D’Alessandro Department of Health Promotion and of Maternal and Child, Internal, and Specialist Medicine (PROMISE), 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


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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 50-70 years population and companions asymptomatic and without CVD.
METHODS: History of CVD, risk factors (RFs), 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 RFs, 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 help to stratify CV risk in primary prevention. Carotid ultrasound furtherly increases the power of stratification of asymptomatic patients suitable for pharmacological treatment.


KEY WORDS: Risk factors; EUROSCORE card; Ecocolordoppler of supra-aortic trunks; Intima-media thickness; Asymptomatic carotid plaque < 50%; Asymptomatic carotid plaque > 50%; 12 leads electrocardiogram

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