Comparing Carotid Artery Velocities with Current ASCVD Risk Stratification: A Novel Approach to Simpler Risk Assessment

Abstract Purpose To explore the potential of a novel approach to simplify risk assessment by comparing carotid artery velocities with current atherosclerotic cardiovascular disease (ASCVD) risk stratification method using nonlinear measurements. Methods In this prospective study conducted at a medic...

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Main Authors: Yueh-Chien Lu, Po-Ju Chen, Sheng-Nan Lu, Fu-Wen Liang, Hung-Yi Chuang
Format: Article
Language:English
Published: Springer 2024-09-01
Series:Journal of Epidemiology and Global Health
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Online Access:https://doi.org/10.1007/s44197-024-00308-3
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author Yueh-Chien Lu
Po-Ju Chen
Sheng-Nan Lu
Fu-Wen Liang
Hung-Yi Chuang
author_facet Yueh-Chien Lu
Po-Ju Chen
Sheng-Nan Lu
Fu-Wen Liang
Hung-Yi Chuang
author_sort Yueh-Chien Lu
collection DOAJ
description Abstract Purpose To explore the potential of a novel approach to simplify risk assessment by comparing carotid artery velocities with current atherosclerotic cardiovascular disease (ASCVD) risk stratification method using nonlinear measurements. Methods In this prospective study conducted at a medical center in southern Taiwan from January 1, 2020, to December 31, 2021, 1636 participants aged 40–75 years without prior ASCVD events were enrolled. Carotid flow velocity was obtained through duplex ultrasonography. ASCVD risk was categorized into two groups according to the 2022 USPSTF guidelines for primary prevention. We analyzed associations between flow indices and ASCVD risk using logistic regression and generalized additive models (GAMs). Results The end diastolic velocity (EDV) of common carotid artery (CCA) and the peak systolic velocity (PSV) of internal carotid artery (ICA) were inversely and nonlinearly associated with cardiovascular event risk. Multivariate logistic regression analysis with ROC curves revealed that the optimal speed for the EDV of CCA was approximately 23.75 cm/s, and the optimal PSV and EDV of ICA were approximately 81.75 cm/s and 26.75 cm/s, respectively. The GAMs showed U-shaped relationships between elevated ASCVD risk and blood flow velocity in the carotid arteries, with inflection points of approximately 82 cm/s in the PSV of ICA and near 25 cm/s in the EDV of CCA. Both methods revealed similar results. Conclusions The EDVs and PSVs of the CCA and ICA are associated with the development of cardiovascular events. Optimal velocity ranges were identified; however, further hemodynamic investigations are warranted.
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spelling doaj-art-6c807e576e6448c482e3e37a4e84f7082025-08-20T01:57:11ZengSpringerJournal of Epidemiology and Global Health2210-60142024-09-011441569157810.1007/s44197-024-00308-3Comparing Carotid Artery Velocities with Current ASCVD Risk Stratification: A Novel Approach to Simpler Risk AssessmentYueh-Chien Lu0Po-Ju Chen1Sheng-Nan Lu2Fu-Wen Liang3Hung-Yi Chuang4Department of Occupational Medicine, Kaohsiung Chang Gung Memorial HospitalDepartment of Occupational Medicine, Kaohsiung Chang Gung Memorial HospitalChang Gung University College of MedicineDepartment of Public Health, College of Health Sciences, Kaohsiung Medical UniversityDepartment of Community Medicine, Kaohsiung Medical University HospitalAbstract Purpose To explore the potential of a novel approach to simplify risk assessment by comparing carotid artery velocities with current atherosclerotic cardiovascular disease (ASCVD) risk stratification method using nonlinear measurements. Methods In this prospective study conducted at a medical center in southern Taiwan from January 1, 2020, to December 31, 2021, 1636 participants aged 40–75 years without prior ASCVD events were enrolled. Carotid flow velocity was obtained through duplex ultrasonography. ASCVD risk was categorized into two groups according to the 2022 USPSTF guidelines for primary prevention. We analyzed associations between flow indices and ASCVD risk using logistic regression and generalized additive models (GAMs). Results The end diastolic velocity (EDV) of common carotid artery (CCA) and the peak systolic velocity (PSV) of internal carotid artery (ICA) were inversely and nonlinearly associated with cardiovascular event risk. Multivariate logistic regression analysis with ROC curves revealed that the optimal speed for the EDV of CCA was approximately 23.75 cm/s, and the optimal PSV and EDV of ICA were approximately 81.75 cm/s and 26.75 cm/s, respectively. The GAMs showed U-shaped relationships between elevated ASCVD risk and blood flow velocity in the carotid arteries, with inflection points of approximately 82 cm/s in the PSV of ICA and near 25 cm/s in the EDV of CCA. Both methods revealed similar results. Conclusions The EDVs and PSVs of the CCA and ICA are associated with the development of cardiovascular events. Optimal velocity ranges were identified; however, further hemodynamic investigations are warranted.https://doi.org/10.1007/s44197-024-00308-3Atherosclerotic cardiovascular disease riskCarotid artery velocityDuplex ultrasonographyGeneralized additive model
spellingShingle Yueh-Chien Lu
Po-Ju Chen
Sheng-Nan Lu
Fu-Wen Liang
Hung-Yi Chuang
Comparing Carotid Artery Velocities with Current ASCVD Risk Stratification: A Novel Approach to Simpler Risk Assessment
Journal of Epidemiology and Global Health
Atherosclerotic cardiovascular disease risk
Carotid artery velocity
Duplex ultrasonography
Generalized additive model
title Comparing Carotid Artery Velocities with Current ASCVD Risk Stratification: A Novel Approach to Simpler Risk Assessment
title_full Comparing Carotid Artery Velocities with Current ASCVD Risk Stratification: A Novel Approach to Simpler Risk Assessment
title_fullStr Comparing Carotid Artery Velocities with Current ASCVD Risk Stratification: A Novel Approach to Simpler Risk Assessment
title_full_unstemmed Comparing Carotid Artery Velocities with Current ASCVD Risk Stratification: A Novel Approach to Simpler Risk Assessment
title_short Comparing Carotid Artery Velocities with Current ASCVD Risk Stratification: A Novel Approach to Simpler Risk Assessment
title_sort comparing carotid artery velocities with current ascvd risk stratification a novel approach to simpler risk assessment
topic Atherosclerotic cardiovascular disease risk
Carotid artery velocity
Duplex ultrasonography
Generalized additive model
url https://doi.org/10.1007/s44197-024-00308-3
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