Screening for asymptomatic cardiovascular disease with noninvasive imaging in patients at high-risk and low-risk according to the European Guidelines on Cardiovascular Disease Prevention: the SMART study

Journal of Vascular Surgery
Bertine M B GoessensSMART Study Group

Abstract

To assess the prevalence of atherosclerotic risk factors and to investigate the added value of noninvasive imaging in detecting asymptomatic cardiovascular diseases in patients at low risk and high risk according to the European Guidelines on Cardiovascular Disease Prevention. In the vascular screening program of the University Medical Center Utrecht, patients aged 18 to 79 years who had recently received a diagnosis of manifest vascular disease (coronary heart disease, cerebrovascular disease, abdominal aortic aneurysm, or peripheral arterial disease [PAD]) or had a risk factor (hypertension, hyperlipidemia, or diabetes mellitus) were assessed for atherosclerotic risk factors and (other) arterial diseases by noninvasive means. The European guidelines were applied to quantify the number of high-risk patients. Eighty-eight percent of 3950 patients were considered to be at high-risk. More than 80% had hyperlipidemia, approximately 50% had hypertension, 21% had diabetes mellitus, and 31% were current smokers. An asymptomatic reduced ankle-brachial index (< or = 0.90) was most frequently observed in patients with cerebrovascular disease (21%); an asymptomatic abdominal aortic aneurysm (> or = 3.0 cm) in patients with PAD (5%) or ce...Continue Reading

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