Editorial comment--Vascular thickness and calcification as markers of atherosclerotic burden.

Abstract

The study by Hollander et al1 provides an uncommon opportunity to directly compare the predictive value of various noninvasive tests of atherosclerotic burden for stroke in community dwellers. The study included a cohort of ≈7000 stroke-free subjects. Slightly more than half of the subjects had a complete set of measures of carotid plaque, carotid intima-media thickness (IMT), ankle-arm index, and aortic calcification. Study participants were followed up for a mean of 6.1 years. On the basis of point estimates, measures of carotid IMT and aortic calcifications were stronger determinants of stroke than measures of carotid plaque and ankle-arm index. Carotid IMT, the most potent risk factor assessed in the study, imparted a relative risk of stroke of 2.23 for values in the highest tertile. Ankle-arm index, the least potent risk factor, imparted a relative risk of stroke of 1.55 for values in the lowest tertile. Investigators also found that carotid IMT and aortic calcifications were independent risk factors. Statistical independence suggests …