Information for Physicians
Traditional risk factor analysis is not enough. Many patients with with vascular disease have low cholesterol and low risk scores. Unfortunately these people can have a sudden heart attack or stroke without anyone knowing that they were at high risk for years before. Studies have shown a great overlap in risk factor profiles in people who do or do not experience events. For example, in one study of patients hospitalized with coronary artery disease, 77% had normal LDL levels, and would not be considered high-risk.
We all know that new risk factors and scoring schemes are proposed quite frequently. The traditional risk factor approach does not necessarily work so well for the individual patient, and is by definition just a statistical approximation, not of great predictive value for each individual.
Treat the patient, not the risk factors: Patients can really be misclassified without you knowing it. Especially misleading can be the intermediate Framingham risk group, these patients are frequently re-classified to higher or LOWER risk strata when CIMT is considered. (Stein,JH, Johnson HM JACC 2010; 55:1608-1610)
Measuring vascular thickness can help fill this gap. CIMT offers direct visualization of SUBCLINICAL atherosclerosis, can help you better assess your patient’s risk and guide future management.
We can arrange for you to offer this test as a service to your patients in your own office. It can also be done at free standing imaging centers (see outpatient locations) on your order. The procedure is not covered by insurance in this part of the country. Please call us to discuss further at 803-754-2600.
The SHAPE Society
The Society for Heart Attack Prevention and Eradication website: www.shapesociety.org is a Professional Site that discusses the rationale and need for this type of screening, role of risk factor analysis, why usual risk factor scoring is not enough in the asymptomatic population, etc. There are extensive representations and references here. They also have a youtube site with interviews with experts, etc.
We are a SHAPE certified Heart Attack Prevention site.