Carotid ultrasound screening for coronary heart disease: results based on a meta-analysis of 18 studies and 44,861 subjects

J Med Screen 2009;16:147-154
doi:10.1258/jms.2009.009038
© 2009 Medical Screening Society

 

This Article
Right arrow
Figures Only
Right arrow
Full Text
Right arrow

Full Text (PDF)

Right arrow
Alert me when this article is cited
Right arrow
Alert me if a correction is posted
Services
Right arrow
Email this article to a friend
Right arrow

Similar articles in this journal

Right arrow
Similar articles in PubMed
Right arrow
Alert me to new issues of the journal
Right arrow
Download to citation manager
Right arrow
Citing Articles
Right arrow
Citing Articles via HighWire
Right arrow

Citing Articles via Web of Science (2)

Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow
Articles by Wald, D. S
Right arrow
Articles by Bestwick, J. P
Right arrow Search for Related Content
PubMed
Right arrow
PubMed Citation
Social Bookmarking

What’s this?


Original Articles


David S Wald, MD, MRCP, Consultant Cardiologist and Senior Lecturer 
,


Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK


Jonathan P Bestwick, MSc, Statistician
,


Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK

Correspondence to: David S Wald, Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK; d.s.wald{at}qmul.ac.uk


Background Carotid artery ultrasound is a possible screening test for futurecoronary heart disease (CHD) events to select individuals forpreventive treatment.

Objectives To assess the screening performance of carotid artery intima-mediathickness (IMT) and carotid plaque in the identification ofindividuals with CHD.

Methods Meta-analysis of case-control and cohort studies, reportingcarotid IMT or plaque in individuals with and without CHD. Screeningperformance (detection rates [DRs] for specified false-positiverates [FPRs]) was assessed from the relative Gaussian distributionsof IMT among individuals with and without CHD and from the proportionof affected and unaffected individuals with plaque.

Results Eighteen studies, involving 2920 individuals with CHD (mean age range 46–73 years) and 41,941 without (aged 44–73 years) were included in the meta-analysis. For plaque the DR was 62% for an FPR of 30%; likelihood ratio (2.1 [95% CI 1.6–2.4]). For IMT, the DR was 65% for the same 30% FPR (IMT cut-off ≥0.82mm); likelihood ratio 2.2 (1.9–2.5). The results weresimilar in case-control and cohort studies.

Conclusion Neither carotid plaque nor IMT has a CHD screening performancethat is sufficiently discriminatory between affected and unaffectedindividuals to be a worthwhile screening test.


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What’s this?






This article has been cited by other articles:

Home page J Med ScreenHome page

D. S Wald, J. P Bestwick, G. Morton, L. Drummond, N. Jenkins, P. Khodabakhsh, and N. P Curzen
Combining carotid intima-media thickness with carotid plaque on screening for coronary heart disease
J Med Screen,

September 1, 2009;

16(3):

155 – 159.

[Abstract]
[Full Text]
[PDF]




Leave a Comment