Correlation between known atherosclerotic cardiovascular risk factors and the maximum carotid plaque height among executive check-up unit patients in a tertiary hospital
Authors: Roderos RA , Vasquez NP , Junia A 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
As the development of atherosclerotic cardiovascular disease (ASCVD) involves several traditional risk factors, such as age, sex, elevated blood glucose, dyslipidemia, hypertension, obesity, family history, and smoking, assessment based on conventional risk factors is recommended in identifying individuals who at risk for ASCVD. Estimating risk through these factors has performed poorly; thus, non-invasive and inexpensive methods for identifying the presence of subclinical atherosclerosis in these patients are warranted. Present data suggest that the simpler maximum carotid plaque height (MCPH) predicted cardiovascular events similar to the more comprehensive carotid plaque burden, whereas intima-media thickness (IMT) did not. This concept, however, has not yet been validated in the Philippine population.

Purpose
To determine if there is a significant correlation between known ASCVD risk factors and the MCPH among Executive Check-Up Unit (ECU) patients in a tertiary hospital from January to December 2019.

Methods
This is an analytical cross-sectional study done in a private tertiary hospital from January to September 2021. The clinical profile of patients along with identified risk factors were collated and tabulated. Previous carotid ultrasound studies retrieved were then examined by a high-resolution ultrasonographic unit with a linear array transducer. Clear images were captured digitally to allow electronic measurement of the MCPH by a clinical research fellow in peripheral vascular medicine.

Results
A total of 589 patients were included in the study. The mean age of the patients was 50.4 years old. Three hundred sixty-three were male, while 226 were female. One hundred fourteen were found to have diabetes, 22 patients had proteinuria and 79 patients had left ventricular hypertrophy. A total of 57 patients had only one risk factor, 142 patients had two risk factors, 175 patients had three risk factors, 129 patients had four risk factors, 47 had five risk factors, 8 patients had six risk factors and, only one patient had seven risk factors present. Eight-two patients were classified as having Grade I MCPH, 137 patients had Grade II MCPH, while 22 patients were classified as Grade III MCPH. Results showed that the number of risk factors and the MCPH are significantly correlated. The coefficient suggested that the correlation was positive.

Conclusion
Risk factors individually identified to positively correlate with the MCPH were age, fasting blood glucose, glycosylated hemoglobin, proteinuria, and left ventricular hypertrophy. On the other hand, there was no significant correlation between sex, body mass index, hypertension, low density lipoprotein, and the MCPH. Notably, there was a significant correlation between the number of ASCVD risk factors and the MCPH of the study population: as the number of risk factors increased, the maximum plaque height grade also increased.