Assessing the Relationship between Atherosclerotic Cardiovascular Disease Risk Score and Carotid Artery Imaging Findings

J Neuroimaging. 2019 Jan;29(1):119-125. doi: 10.1111/jon.12573. Epub 2018 Oct 25.


Background and purpose: To characterize the relationship between computed tomography angiography (CTA) imaging characteristics of carotid artery and the 10-year risk of atherosclerotic cardiovascular disease (ASCVD) score.

Methods: We retrospectively identified all patients who underwent a cervical CTA at our institution from January 2013 to July 2016, extracted clinical information, and calculated the 10-year ASCVD score using the Pooled Cohort Equations from the 2013 ACC/AHA guidelines. We compared the imaging features of artery atherosclerosis derived from the CTAs between low and high risk.

Results: One hundred forty-six patients met our inclusion criteria. Patients with an ASCVD score ≥7.5% (64.4%) had significantly more arterial stenosis than patients with an ASCVD score <7.5% (35.6%, P < .001). Maximal plaque thickness was significantly higher (mean 2.33 vs. .42 mm, P < .001) and soft plaques (55.3% vs. 13.5%, P < .001) were significantly more frequent in patients with an ASCVD score ≥7.5%. However, among patients with a 10-year ASCVD score ≥7.5%, 33 (35.1%) had no arterial stenosis, 35 (37.2%) had a maximal plaque thickness less than. 9 mm, and 42 (44.7%) had no soft plaque. Furthermore, among the patients with a 10-year ASCVD score <7.5%, 8 (15.4%) had some arterial stenosis, 8 (15.4%) had a maximal plaque thickness more than. 9 mm, and 7 (13.5%) had soft plaque.

Conclusion: There is some concordance but not a perfect overlap between the 10-year ASCVD risk scores calculated from clinical and blood assessment and carotid artery imaging findings.

Keywords: 10-Year ASCVD score; carotid arteries; cervical CTA; computed tomography angiography; vertebral arteries.

MeSH terms

  • Adult
  • Aged
  • Atherosclerosis / diagnostic imaging*
  • Cardiovascular Diseases / diagnostic imaging*
  • Carotid Arteries / diagnostic imaging*
  • Computed Tomography Angiography / methods
  • Female
  • Humans
  • Male
  • Middle Aged
  • Plaque, Atherosclerotic / diagnostic imaging
  • Retrospective Studies
  • Risk Assessment / methods
  • Risk Factors
  • Tomography, X-Ray Computed
  • Ultrasonography