Evidence mapPaperPMID 28279371Full record

Trial reportJACC. Cardiovascular imaging2017

Carotid Plaque Lipid Content and Fibrous Cap Status Predict Systemic CV Outcomes: The MRI Substudy in AIM-HIGH.

Jie Sun, Xue-Qiao Zhao, Niranjan Balu, Moni B Neradilek, Daniel A Isquith, Kiyofumi Yamada, Gádor Cantón, John R Crouse, Todd J Anderson, John Huston and 5 more

Registry-linked trialAbstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in JACC. Cardiovascular imaging, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It reports registered trial NCT00880178. Cited by 59 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
59citing papers in PubMed, 4 pooled it
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00880178 completed

Plaque Inflammation and Dysfunctional HDL in AIM-HIGH

Ran2008Enrolled324Registered outcomes5Posted comparisons0ConditionsAtherosclerosis, Cardiovascular Diseases, Coronary Disease, Heart DiseasesArmssimvastatin, Simvastatin and Extended-Release niacin
Open the trial in the graph
3 · Its place in the literature

Who cites it

59 citing papers in PubMed, 4 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

15 authors.

Jie SunDepartment of Radiology, University of Washington, Seattle, Washington.
Xue-Qiao ZhaoDepartment of Medicine, University of Washington, Seattle, Washington.
Niranjan BaluDepartment of Radiology, University of Washington, Seattle, Washington.
Moni B NeradilekThe Mountain-Whisper-Light Statistics, Seattle, Washington.
Daniel A IsquithDepartment of Medicine, University of Washington, Seattle, Washington.
Kiyofumi YamadaDepartment of Radiology, University of Washington, Seattle, Washington.
Gádor CantónDepartment of Mechanical Engineering, University of Washington, Seattle, Washington.
John R CrouseDepartment of Medicine, Wake Forest University, Winston-Salem, North Carolina.
Todd J AndersonLibin Cardiovascular Institute of Alberta and Cumming School of Medicine, Calgary, Alberta, Canada.
John HustonDepartment of Radiology, Mayo Clinic, Rochester, Minnesota.
Kevin O'BrienDepartment of Medicine, University of Washington, Seattle, Washington.
Daniel S HippeDepartment of Radiology, University of Washington, Seattle, Washington.
Nayak L PolissarThe Mountain-Whisper-Light Statistics, Seattle, Washington.
Chun YuanDepartment of Radiology, University of Washington, Seattle, Washington.
Thomas S HatsukamiDepartment of Surgery, University of Washington, Seattle, Washington. Electronic address: tomhat@u.washington.edu.

Funding

NHLBI NIH HHS R01 HL088214NHLBI NIH HHS R01 HL089504NHLBI NIH HHS R01 HL103609NINDS NIH HHS R01 NS083503
6 · The paper itself

Abstract

objectivesThe aim of this study was to investigate whether and what carotid plaque characteristics predict systemic cardiovascular outcomes in patients with clinically established atherosclerotic disease.

backgroundAdvancements in atherosclerosis imaging have allowed assessment of various plaque characteristics, some of which are more directly linked to the pathogenesis of acute cardiovascular events compared to plaque burden.

methodsAs part of the event-driven clinical trial AIM-HIGH (Atherothrombosis Intervention in Metabolic Syndrome with Low HDL/High Triglycerides: Impact on Global Health Outcomes), subjects with clinically established atherosclerotic disease underwent multicontrast carotid magnetic resonance imaging (MRI) to detect plaque tissue composition and high-risk features. Prospective associations between MRI measurements and the AIM-HIGH primary endpoint (fatal and nonfatal myocardial infarction, ischemic stroke, hospitalization for acute coronary syndrome, and symptom-driven revascularization) were analyzed using Cox proportional hazards survival models.

resultsOf the 232 subjects recruited, 214 (92.2%) with diagnostic image quality constituted the study population (82% male, mean age 61 ± 9 years, 94% statin use). During median follow-up of 35.1 months, 18 subjects (8.4%) reached the AIM-HIGH endpoint. High lipid content (hazard ratio [HR] per 1 SD increase in percent lipid core volume: 1.57; p = 0.002) and thin/ruptured fibrous cap (HR: 4.31; p = 0.003) in carotid plaques were strongly associated with the AIM-HIGH endpoint. Intraplaque hemorrhage had a low prevalence (8%) and was marginally associated with the AIM-HIGH endpoint (HR: 3.00; p = 0.053). High calcification content (HR per 1 SD increase in percent calcification volume: 0.66; p = 0.20), plaque burden metrics, and clinical risk factors were not significantly associated with the AIM-HIGH endpoint. The associations between carotid plaque characteristics and the AIM-HIGH endpoint changed little after adjusting for clinical risk factors, plaque burden, or AIM-HIGH randomized treatment assignment.

conclusionsAmong patients with clinically established atherosclerotic disease, carotid plaque lipid content and fibrous cap status were strongly associated with systemic cardiovascular outcomes. Markers of carotid plaque vulnerability may serve as novel surrogate markers for systemic atherothrombotic risk.

Indexed as

Magnetic Resonance ImagingPlaque, AtheroscleroticAcute Coronary SyndromeAgedBrain IschemiaCanadaCarotid Artery, CommonCarotid Artery DiseasesDisease-Free SurvivalFemaleFibrosisHospitalizationHumansKaplan-Meier EstimateLipidsMaleLipidsatherosclerosiscardiovascular eventscarotid arterymagnetic resonance imagingsurrogate markervulnerable plaque

Identifiers

PMID28279371
PMCPMC5347460

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.