Tracking atherosclerotic plaque: In the 1600’s, the leading physician in England (Thomas Sydenham, MD) wrote that “A man is as old as his arteries”. We would now change that to “A person is as old as his or her arteries” but Dr. Sydenham’s viewpoint has proven to be accurate and visionary.
At the Kahn Center, patients have extensive lab studies but also have imaging of their carotid arteries using digital imaging (CIMT) and CT imaging of the heart (at least a calcium CT scan or CACS but often a digital AI coronary CT angiogram). If atherosclerosis plaque is identified, in at least 50% of patients, a program is instituted to halt and reverse the disease, and follow-up imaging is scheduled. Does this strategy have academic support? A new and important study says the strategy used at the Kahn Center is the future of cardiology now!
STUDYING PLAQUE
A population of 5,716 asymptomatic U.S. adults (mean age 69 years, 57% female) enrolled between 2008 and 2009 in the BioImage study underwent examination by carotid ultrasound to quantify carotid plaque burden (cPB) (the sum of right and left carotid plaque areas) and by computed tomography for coronary artery calcium scoring (CACS). Follow-up carotid vascular ultrasound was performed on 732 participants a median of 9 years after the baseline exam. All participants were followed up for all-cause mortality, the primary outcome.
RESULTS
Over a median 12-year follow-up, 901 (16%) participants died.
After adjustment for cardiovascular risk factors and background medication, both the baseline carotid ultrasound and CACS score were both significantly associated with all-cause mortality.
The carotid ultrasound performed better than the CAC score.
In participants with a second carotid ultrasound evaluation, the progression of plaque in the carotid arteries was significantly associated with all-cause mortality after adjusting for cardiovascular risk factors.
CONCLUSIONS
This study is very important and supports the way patients are managed at the Kahn Center. Silent and “subclinical” atherosclerosis found in the carotid artery (CIMT) or in the coronary arteries (CACS) in asymptomatic individuals was independently associated with all-cause mortality. Moreover, atherosclerosis progression was independently associated with all-cause mortality.
Unfortunately, current practice patterns recommend cancer screening like mammography and colonoscopy, but artery screening is not a routine recommendation though it is the long-time pattern at the Kahn Center.
It is time to add carotid and heart screening studies to the routine check-up at age 45-50 years and periodically thereafter.
The study did not evaluate the newer coronary CT angiogram with AI interpretation (Cleerly Health), a breakthrough advance that adds precise plaque measurements and plaque characterization.
The future is bright!
About the author: Dr. Joel Kahn is one of the world’s top cardiologists and he is passionate about scientifically showing the body’s ability to heal itself through proper nutrition. He is on a mission to try to prevent all future heart attacks by educating and inspiring people to follow an active and holistic lifestyle by applying cutting-edge science to their lives.
At his core, Dr. Joel Kahn believes that plant-based nutrition is the most powerful source of preventative medicine on the planet. Having practiced traditional cardiology since 1983, it was only after his own commitment to a plant-based vegan diet that Dr. Kahn truly began to delve into the realm of non-traditional diagnostic tools, prevention tactics, and nutrition-based recovery protocols.
As with anything you read on the internet, this article should not be construed as medical advice; please talk to your doctor or primary care provider before changing your wellness routine. WHN does not agree or disagree with any of the materials posted. This article is not intended to provide a medical diagnosis, recommendation, treatment, or endorsement. Additionally, it is not intended to malign any religion, ethnic group, club, organization, company, individual, or anyone or anything. These statements have not been evaluated by the Food and Drug Administration.
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References/Sources/Materials provided by:
https://www.jacc.org/doi/10.1016/j.jacc.2024.06.045
https://worldhealth.net/news/how-reverse-atherosclerosis-heart-disease-and-more/