Abstract 9829: Subclinical Atherosclerosis in Asymptomatic Subjects Referred for Risk Stratification: A Comparison of Carotid Ultrasound, Coronary Artery Calcium Scoring and Coronary Computed Tomography Angiography
Bibliographic record
Abstract
Introduction: In subjects free of known vascular disease, current guidelines recommend lipid targets according to global risk of cardiovascular events. In select populations, imaging is recommended for refining clinical risk. The purpose of this study was to compare three imaging modalities coronary artery calcium scoring (CACS), carotid ultrasound (US) and coronary computed tomography angiography (CCTA) in a population referred for risk stratification. Hypothesis: We hypothesized that diverse definitions of early atherosclerosis utilized by differing modalities would affect perceived prevalence of subclinical atherosclerosis and consequently, assessment of risk. We sought to determine the degree of concordance among these definitions. Methods: Subjects free of known vascular disease scheduled to undergo a carotid US for clinical risk stratification were invited to undergo CCTA/CACS. Subjects on lipid lowering therapy > 3 months were excluded. All images were assessed by an experienced core laboratory. Carotid intima media thickness ≥75 th percentile for age and sex, CACS > 0 and detection of either carotid or coronary artery plaque were indicators of atherosclerosis. Results: Fifty patients were included. Median age was 53 years; 54% were men. Atherosclerosis was seen in 28%, 78% and 90% of subjects using CACS, CCTA and carotid US, respectively, with all subjects demonstrating one or more markers or findings on at least one method. In the 36 patients with CACS = 0, 69% and 86% had atherosclerosis on CCTA and carotid US, respectively. Maximal concordance (68%, p = 0.021) between carotid US and CCTA was seen when carotid US showed the presence/absence of any plaque with a maximal thickness of ≥ 1.5 mm. Conclusions: In this detailed analysis, all subjects identified to warrant further risk stratification had findings indicating subclinical atherosclerosis on at least one modality. Concordance between the modalities was highly variable, dependent upon the specific definition used. Carotid US and CCTA detection of plaque were more sensitive than CACS > 0. Given strong evidence for low CV risk in patients with CACS = 0, the threshold of subclinical disease at which to treat using Carotid US or CCTA plaque warrants further consideration and caution.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".