Carotid Intima Media Thickness Versus Carotid Plaque in Cardiovascular Risk Evaluation

Cardiovascular (CV) risk (ie, coronary heart disease [CHD] risk + stroke risk) prediction can be improved with the use of imaging modalities. Carotid intima media thickness (CIMT) and carotid plaque have been used as markers of atherosclerosis and also as predictors of incident CV events. It has been shown that adding either or both to traditional risk prediction models improves CHD risk prediction. There are limited data comparing CIMT and carotid plaque and currently it appears that combining both CIMT and carotid plaque best improves CHD risk prediction. Improvements in ultrasound technology may allow for improved assessment of CIMT, and quantifying and possibly characterizing atherosclerotic plaque in the near future. Whether quantifying plaque will be superior to CIMT measurements or if the combination of both will be the best way to improve CVD (CHD + stroke) risk prediction with ultrasound remains to be seen.