25) A recent meta-analysis provides further evidence that carotid plaque measurements are more strongly predictive of cardiovascular events than measurement of IMT.5)

However, the quantitative measurement of plaques is not standard practice for most Korean cardiologists, and the typical plaque description includes the number of individual plaques, the plaque thickness, and characterization of surrounding tissue, such as calcifications or various patterns of echogenicity. Accordingly, we tried to measure plaque Inhibitors,research,lifescience,medical burden as TPA and TPV according to the validated method in patients with well-established cardiovascular risk factors. While the simple correlations between IMT and plaque measurements were highly and statistically significant, the r-values between 0.4 and 0.6 indicated correlations that were only moderate.

Conversely, there was a strong correlation between plaque measurement Inhibitors,research,lifescience,medical and both TPA and TPV, as large plaque measurements contribute to a large TPA and TPV, which is not always associated with increased IMT. Similarly, if there was only a long, slender plaque overlying the region used for IMT determination, the absence of other plaques contributed to low TPA and TPV for this individual. Thus, IMT does not always reflect total carotid disease burden. Additionally, we empirically measured plaque volume by the area-width Inhibitors,research,lifescience,medical method and compared these parameters with Inhibitors,research,lifescience,medical plaque volume by 3D US, which were shown to have significant positive correlations. However, there seems to be large discrepancies in the values over 200 mm3 in Bland-Altman plot analysis, we think there would be some potential role for this calculation in the assessment of plaque volume in limited cases with CCA plaques. Of course, we recognize that our study is somewhat limited by several factors, including a small sample size and a unique study sample from which the findings may not be generalizable. As this was the first attempt to measure plaque area or volume in Korea, there would understandably Inhibitors,research,lifescience,medical be some technical limitations to plaque measurement. In our study, the golden

standard of TPV old was 3D US measurement and from our experience, 3D assessment of PV in ICA plaque was more difficult than CCA plaque because of angle, however, it was possible and feasibility of 3D PV is about 70-80%. However, for the assessment of 2D area-width PV, because we cannot www.selleckchem.com/epigenetic-reader-domain.html achieve short axis view of ICA and bulb, ICA/bulb plaque could not be measured by this method, and feasibility of 2D PV is about 40-50%. So, it may have resulted in another level of imprecision. Moreover, it was difficult to define plaque border in cases with diffuse plaques connected by increased IMT. In these cases, we tried to measure the plaque border by defining plaque as suggested by Spence et al.4),7) Finally, we did not check TPV by another validated modality such as carotid CT angiography or magnetic resonance imaging.