The role of carotid intimal thickness and plaque imaging in risk stratification for coronary heart disease.

Improving the 10-year coronary heart disease (CHD) risk prediction beyond its current state is important as the current risk prediction schemes classify the majority of individuals who experience an incident CHD event as low or intermediate in risk. B-mode ultrasound-based carotid intima-media thickness (CIMT) measurement and carotid plaque detection is one of the surrogate markers of atherosclerosis that has shown value in CHD risk prediction. It has been shown that adding either CIMT, plaque, or both to traditional risk prediction models improves CHD risk prediction. Carotid ultrasound-based CIMT measurement and plaque identification is noninvasive, safe, and relatively inexpensive. Recent guidelines have given CIMT and plaque-based risk prediction a class II A recommendation. This article reviews the available data related to the use of CIMT and plaque information in CHD risk prediction.