Use of Carotid Ultrasound to Identify Subclinical Vascular Disease and Evaluate Cardiovascular Disease Risk: A Consensus Statement from the American Society of Echocardiography Carotid Intima-Media Thickness Task Force Endorsed by the Society for Vascular Medicine

There is great interest in identifying asymptomatic patients at high risk who might be candidates for more intensive, evidence-based medical interventions that reduce cardiovascular disease (CVD) risk. Measurement of carotid intima-media thickness (CIMT) with B-mode ultrasound is a noninvasive, sensitive, and reproducible technique for identifying and quantifying subclinical vascular disease and for evaluating CVD risk. To address issues of standardization and help improve the availability of experienced clinical laboratories that can perform high-quality CIMT studies, this consensus document provides recommendations for the use of carotid ultrasound for identifying and quantifying subclinical vascular disease and for evaluating CVD risk in clinical practice. Nine published prospective studies that included at least 1000 asymptomatic participants have examined CIMT and CVD risk. Each study demonstrated that CIMT was significantly associated with risk for myocardial infarction, stroke, death from coronary heart disease, or a combination of these events. In most of these studies, the ability of CIMT to predict future CVD events was independent of traditional risk factors. Furthermore, 9 large studies have demonstrated similar or greater predictive power for carotid plaque and CVD.