P1507Role of adjuvant carotid ultrasound in women undergoing stress echocardiography for the assessment of suspected angina with no previous history of coronary artery disease

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
S Gurunathan ◽  
M Shanmuganathan ◽  
R Hampson ◽  
R Khattar ◽  
R Senior
Keyword(s):  
Predictive Value ◽  
Carotid Plaque ◽  
Stress Echocardiography ◽  
Subclinical Atherosclerosis ◽  
Previous History ◽  
Scoring Systems ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Assessment Tools ◽  
Carotid Ultrasound

Abstract Introduction Traditional risk assessment tools classify the majority of women at low risk despite cardiovascular disease remaining the leading cause of death in women. Additionally conventional stress testing techniques have poor predictive value in women, due to unique pathophysiological mechanisms causing ischaemia in women, and the lower prevalence of obstructive CAD. The study sought to evaluate the role of adjuvant carotid ultrasound (CU) in women attending for stress echocardiography (SE). Methods and results 415 women (Mean age 62±10 years, 28% Diabetes Mellitus, Mean BMI 28) attending for SE prospectively underwent CU, to assess Carotid Intima-media thickness (CIMT) and the presence of plaque. 47 women (11%) had inducible wall motion abnormalities, and carotid disease (CD) was present in 46% (Carotid plaque in 41%, 15% CIMT >75th percentile). Women with CD were older (65 vs 58 years, p<0.0001), more likely to have Diabetes (41% vs 21%, p=0.0001) and hypertension (67% vs 36%, p<0.01), and had higher pretest probability of CAD (59% vs 41%, p<0.0001). 40% of women classified as low Framingham, were found to have evidence of CD. Conversely, only 40% of women classified as high Framingham risk, had CD. The positive predictive value of SE for flow-limiting CAD was 51%, but the presence of carotid plaque improved this to 71% (p<0.01). Of all clinical and test parameters, carotid plaque (p=0.001) and SE result (p=0.01) were the only independent predictors of >70% angiographic. Conclusion CU significantly improves the accuracy of SE alone for identifying flow-limiting disease on coronary angiography. Non-invasive assessment of subclinical atherosclerosis using CU offers an individualized disease-guided approach in women, where conventional scoring systems offer modest risk stratification.

Abstract 247: Association of Soluble RAGE Levels with Carotid Atherosclerosis: The Northern Manhattan Study (NOMAS)

2013 ◽  
Vol 33 (suppl_1) ◽  
Author(s):  
Barry I Hudson ◽  
Hannah Gardener ◽  
Wen Liu-Mares ◽  
Chuanhui Dong ◽  
Sandino Cespedes ◽  
...  
Keyword(s):  
Carotid Plaque ◽  
Minority Groups ◽  
Subclinical Atherosclerosis ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Serum Levels ◽  
Plaque Morphology ◽  
Disease States ◽  
Soluble Rage ◽  
Novel Target

Introduction The Receptor for Advanced Glycation End-products (RAGE) is a multi-ligand receptor that propagates vascular cell dysfunction leading to proinflammatory disease states. RAGE is produced as a membrane bound and soluble isoform (soluble RAGE (sRAGE)), with the soluble isoform demonstrated to act as a RAGE decoy preventing cellular activation and atherosclerosis. Recent cohort studies have suggested that serum levels of sRAGE are associated with the risk of CVD and therefore may be a novel biomarker for cardiovascular disease states. Hypothesis We hypothesized that sRAGE levels are associated with subclinical atherosclerosis in an ethnically diverse population. Methods We included 1,102 stroke-free participants from the multi-ethnic Northern Manhattan Study (NOMAS) who underwent high-resolution carotid B-mode ultrasound to measure carotid plaque phenotypes (density, thickness, and area) and carotid intima-media thickness (IMT). Plaque density was characterized by Gray Scale Median (GSM). Serum sRAGE was measured by ELISA and log-transformed to stabilize variance. Multiple linear and logistic regressions were employed to estimate sRAGE associations with IMT and plaque measures. Results The mean age at time of ultrasound was 70.7±8.6yrs; 65% were Hispanic, 19% black, and 16% white. The majority of subjects had carotid plaque present (54%) with the median GSM 38(0-190). Mean plaque thickness (IQR) was 1.30(0-3.99)mm and mean area (IQR) 2.43(0-96.75)mm2. Mean IMT was 0.93±0.09mm. High sRAGE levels were associated with more echolucent plaques (OR 1.2, 95% CI 1.03-1.42), especially among Hispanics (OR 1.26, 95% CI 1.04-1.54). These relationships remained after adjusting for sociodemographic and vascular risk factors. No association was seen between sRAGE levels and carotid IMT, plaque thickness or area. Conclusion In the present study, higher sRAGE levels were associated with echolucent (lower density) plaque, especially among Hispanic subjects. Our data suggest sRAGE levels may be associated with atherosclerotic plaque morphology and its vulnerability, especially among minority groups. These findings further support RAGE as a novel target for anti-atherosclerosis interventions.

Abstract 17791: Yield of Different Approaches for Screening for Cardiovascular Disease in Asymptomatic Diabetics

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Timothy W Churchill ◽  
Carlos H Rassi ◽  
Carlos A Fernandes Tavares ◽  
Mateus G Fahel ◽  
Fabricia P Rassi ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Coronary Artery ◽  
Coronary Stenosis ◽  
Carotid Plaque ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Coronary Plaque ◽  
Carotid Ultrasound ◽  
Asymptomatic Subjects ◽  
A Prospective Study

Introduction: While diabetes has long been considered a coronary heart disease equivalent, there is increasing evidence to suggest that not all individuals with diabetes have cardiovascular disease, and it is unclear how best to risk stratify this population. We sought to compare the yield of testing for pre-clinical atherosclerosis with various approaches. Methods: A group of 98 asymptomatic subjects with type 2 diabetes mellitus (T2DM) without known coronary artery disease (CAD) were enrolled in a prospective study and underwent carotid ultrasound, exercise treadmill testing (ETT), coronary artery calcium (CAC) scoring, and coronary computed tomography angiography (CTA). CTA was used as the reference standard for CAD. Results: Of 98 subjects (average age 55±6, 64% female, 22 on insulin, mean A1c 7.3%), 43 (44%) had coronary plaque detectable on CTA, and 38 (39%) had CAC score > 0. By CTA, 16 (16%) had coronary stenosis ≥ 50%, including 3 subjects with CAC=0. Subjects with coronary plaque had greater prevalence of carotid plaque (58% vs. 38%, p=0.01) and greater carotid intima media thickness (0.80±0.20 mm vs. 0.70±0.11mm, p=0.02). However, 18 of the 55 subjects (33%) with normal CTA had carotid plaque. Eight subjects had a positive ETT, of whom 5 had ≥ 50% coronary stenosis and 2 had <50% stenosis, but there was no difference in METS achieved between subjects with and without plaque (8.2 vs. 8.7, p=0.19). Test characteristics of different imaging modalities for prediction of coronary plaque are shown in Figure 1. Conclusion: Among asymptomatic subjects with T2DM, a majority (56%) had no CAD by CTA. CAC was the most accurate screening modality for detection of CAD while ETT and carotid ultrasound had a limited sensitivity. Interestingly, 33% of subjects with normal CTA had carotid plaque. Further studies are needed to better characterize stroke risk in such patients and whether there is a role for screening for carotid plaque in diabetics without CAC or with normal CTA.

scholarly journals Role of adjuvant carotid ultrasound in women undergoing stress echocardiography for the assessment of suspected coronary artery disease

Open Heart ◽  
2020 ◽  
Vol 7 (1) ◽  
pp. e001188
Author(s):  
Sothinathan Gurunathan ◽  
Mayooran Shanmuganathan ◽  
Reinette Hampson ◽  
Rajdeep Khattar ◽  
Roxy Senior
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Predictive Value ◽  
Carotid Plaque ◽  
Stress Echocardiography ◽  
Risk Scores ◽  
Plaque Burden ◽  
Carotid Ultrasound ◽  
Artery Disease

ObjectiveDue to the low prevalence of obstructive coronary artery disease (CAD) in women, stress testing has a relatively low predictive value for this. Additionally, conventional cardiovascular risk scores underestimate risk in women. This study sought to evaluate the role of atherosclerosis assessment using carotid ultrasound (CU) in women attending for stress echocardiography (SE).MethodsThis was a prospective study in which consecutive women with recent-onset suspected angina, who were referred for clinically indicated SE, underwent CU.Results415 women (mean age 61±10 years, 29% diabetes mellitus, mean body mass index 28) attending for SE underwent CU. 47 women (11%) had inducible wall motion abnormalities, and carotid disease (CD) was present in 46% (carotid plaque in 41%, carotid intima-media thickness >75th percentile in 15%). Women with CD were older (65 vs 58 years, p<0.001), and more likely to have diabetes (41% vs 21%, p=0.001), hypertension (67% vs 36%, p<0.01) and a higher pretest probability of CAD (59% vs 41%, p<0.001). 40% of women classified as low Framingham risk were found to have evidence of CD.The positive predictive value of SE for flow-limiting CAD was 51%, but with the presence of carotid plaque, this was 71% (p<0.01). Carotid plaque (p=0.004) and ischaemia (p=0.01) were the only independent predictors of >70% angiographic stenosis. In women with ischaemia on SE and no carotid plaque, the negative predictive value for flow-limiting disease was 88%.During a follow-up of 1058±234 days, there were 15 events (defined as all-cause mortality, non-fatal myocardial infarction, heart failure admissions and late coronary revascularisation). Age (HR 1.07 (1.00–1.15), p=0.04), carotid plaque burden (HR 1.65 (1.36–2.00), p<0.001) and ischaemic burden (HR 1.41 (1.18–1.68), p<0.001) were associated with outcome. There was a stepwise increase in events/year from 0.3% when there were no ischaemia and atherosclerosis, 1.1% when there was atherosclerosis and no ischaemia, 2.2% when there was ischaemia and no atherosclerosis and 10% when there were both ischaemia and atherosclerosis (p<0.001).ConclusionCU significantly improves the accuracy of SE alone for identifying flow-limiting disease on coronary angiography, and improves risk stratification in women attending for SE, as well identifying a subset of women who may benefit from primary preventative measures.

scholarly journals Prevalence of Microalbuminuria and Its Association with Subclinical Carotid Atherosclerosis in Middle Aged, Nondiabetic, Low to Moderate Cardiovascular Risk Individuals with or without Hypertension

Diagnostics ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. 1716
Author(s):  
Eva Szabóová ◽  
Alexandra Lisovszki ◽  
Eliška Fatľová ◽  
Peter Kolarčik ◽  
Peter Szabó ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Carotid Plaque ◽  
Subclinical Atherosclerosis ◽  
Multiple Logistic Regression Analysis ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Functional Markers ◽  
Middle Aged ◽  
Media Thickness

Microalbuminuria is closely associated with the risk of cardiovascular disease and all-cause mortality in the general population. Less is known about its relationship with subclinical atherosclerosis. We aimed to assess the prevalence of microalbuminuria and its relationship with subclinical atherosclerosis in middle-aged, nondiabetic, apparently healthy individuals (N = 187; 40.1% men, 59.9% women; aged 35–55 years) as well as to evaluate its potential associations with established risk modifiers, especially with the presence of carotid plaque. Clinical and laboratory parameters, the estimated 10-year fatal cardiovascular risk (SCORE), as well as circulating, functional (flow mediated vasodilation, ankle-brachial index, augmentation index, and pulse wave velocity), and morphological markers (mean carotid intima–media thickness, and carotid plaque) of subclinical atherosclerosis were analysed in group with vs. without microalbuminuria. Microalbuminuria was present in 3.8% of individuals with SCORE risk 0.43 ± 0.79%. Functional markers predominated in both groups. Carotid intima–media thickness (mean ± SD) in both groups was in range: 0.5–0.55 ± 0.09–0.14 mm. Carotid plaque was more frequent in group with (14.3%) vs. without (4.4%) microalbuminuria. Microalbuminuria had no statistically significant effect on most markers of subclinical atherosclerosis, but the increasing value of microalbuminuria was significantly associated with the occurrence of carotid plaque (p = 0.035; OR = 1.035; 95% CI = 1.002–1.07). Additional multiple logistic regression analysis, where variables belonged to microalbuminuria, number of risk factors, and family history, finally showed only two variables: microalbuminuria (p = 0.034; OR = 1.04; 95%CI = 1.003–1.09) and the number of risk factors (p = 0.006; OR = 2.15; 95% CI = 1.24–3.73) with independent and significant impact on the occurrence of carotid plaque. Our results may indicate an association of microalbuminuria with the presence of carotid atherosclerotic plaque; in addition, microalbuminuria and the number of risk factors appear to be possible predictors of the carotid plaque occurrence. Monitoring microalbuminuria may improve the personalized cardiovascular risk assessment in nondiabetic, low-to-moderate cardiovascular risk individuals with or without hypertension.

Abstract P242: Carotid Plaque Characterization, Stenosis, and Intima-media Thickness According to Age and Gender in a Large Registry Cohort

Circulation ◽  
2016 ◽  
Vol 133 (suppl_1) ◽  
Author(s):  
Nancy M Boulos ◽  
Julius M Gardin ◽  
Shaista Malik ◽  
John Postley ◽  
Nathan D Wong
Keyword(s):  
Carotid Plaque ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Carotid Ultrasound ◽  
Age And Gender ◽  
Media Thickness ◽  
Age Related ◽  
Stenosis Severity ◽  
And Gender ◽  
Soft Plaque

Background: Carotid intima-media thickness (CIMT) is a well-established predictor of cardiovascular disease events. Not well described, however, is the prevalence of plaque and stenosis severity and how this varies according to extent of CIMT, age, and gender. Methods: We evaluated the extent of carotid plaque and stenosis severity according to CIMT, age and gender in a large CIMT screening registry. We studied 9347 women and 12676 men (n=22,023) who received carotid ultrasound scans. The presence and severity of both carotid plaque and stenosis was compared according to extent of CIMT ( > 1 mm vs. <1 mm), age, and gender using the Chi-square test of proportions. Results: Among those aged <45 to > 80 years the prevalence of CIMT > 1 mm ranged from 0.13 to 29.3% in women and 0.6 to 40.1% in men, stenosis >50% from 0.1% to 14.9% in women and 0.1% to 13.2% in men, and mixed/soft plaque from 7.1% to 66.5% in women and 9.2% to 65.8% in men (all p<0.001 across age). While 6.6% of women and 8.5% of men with CIMT <1mm had >30% stenosis, this increased to 48.6% and 46.0%, respectively, in those with CIMT > 1 mm. Even when CIMT levels were <1 mm, >30% of persons demonstrated mixed or soft plaque. Of those with CIMT > 1mm, more than 70% had such mixed or soft plaque (Figure) and over 40% demonstrated stenoses of 30% or greater. Conclusions: We describe in a large CIMT registry study a substantial age-related increase in both men and women of CIMT, plaque presence and severity, as well as stenosis. Even in those with normal CIMT, mixed or soft plaque potentially prone to rupture was common, demonstrating the value in assessing for plaque when doing carotid ultrasound.

scholarly journals Biomarkers of Cardiovascular Stress and Subclinical Atherosclerosis in the Community

2014 ◽  
Vol 60 (11) ◽  
pp. 1402-1408 ◽  
Author(s):  
Deepa M Gopal ◽  
Martin G Larson ◽  
James L Januzzi ◽  
Susan Cheng ◽  
Anahita Ghorbani ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Plaque ◽  
Troponin I ◽  
Subclinical Atherosclerosis ◽  
Logistic Models ◽  
High Sensitivity ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Media Thickness ◽  
Cardiovascular Stress

Abstract BACKGROUND Biomarkers of cardiovascular stress have been associated with incident cardiovascular outcomes. Their relations with measures of subclinical atherosclerosis, as assessed by carotid intima-media thickness, have not been well described. METHODS We measured plasma growth differentiation factor-15 (GDF-15), soluble ST2 (sST2), and high-sensitivity troponin I (hsTnI) in 3111 Framingham Offspring participants who also underwent carotid ultrasonography during the sixth examination (1995–1998, mean age 58 years, 54% women). Carotid measurements included maximal internal carotid artery (ICA) intima-media thickness (IMT), plaque presence (defined as ICA IMT &gt;1.5 mm), and mean common carotid artery IMT. We carried out multivariable regressions for carotid measurements vs biomarkers using linear and logistic models; P &lt; 0.0056 was deemed statistically significant. RESULTS Maximal ICA IMT was significantly associated with plasma GDF-15 [β-estimate 0.04 per 1-U increase in log(GDF-15), SE 0.01, P &lt; 0.0001]. Similarly, the odds of having carotid plaque increased 33% [odds ratio 1.33 per 1-U increase in log(GDF-15), 95% CI 1.20–1.48, P &lt; 0.0001]. In contrast, there was no significant association of maximal ICA IMT or plaque presence with sST2 or hsTnI, and none of the 3 biomarkers was significantly associated with mean CCA IMT. GDF-15 was a stronger predictor of maximal ICA thickness and plaque presence compared with BNP and CRP when these conventional biomarkers were tested together. CONCLUSIONS Increased GDF-15 concentrations are associated with subclinical atherosclerosis, including maximal ICA IMT and carotid plaque presence. Future studies investigating the role of GDF-15 for screening and management of patients with subclinical atherosclerosis are warranted.

P4389Effect of cigarette smoking on carotid artery atherosclerosis: a community-based cohort study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
H Kiriyama ◽  
H Kaneko ◽  
H Itoh ◽  
Y Yoshida ◽  
K Nakanishi ◽  
...  
Keyword(s):  
Cardiovascular Diseases ◽  
High Risk ◽  
Carotid Artery ◽  
Cigarette Smoking ◽  
Carotid Plaque ◽  
Subclinical Atherosclerosis ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Carotid Artery Plaque ◽  
Never Smokers

Abstract Background Cigarette smoking is closely associated with the development of cardiovascular diseases (CVD), and the European Society of Cardiology/European Atherosclerosis Society (ESC/EAS) guidelines recommend smoking bans.On the other hand, the relationship between cigarette smoking and subclinical atherosclerosis has not been fully studied. Carotid intima-media thickness (cIMT) is commonly used as a subclinical atherosclerosis marker, and a carotid plaque feature is also known to be an important predictor of cardiovascular diseases. Purpose We sought to clarify the association between cigarette smoking and subclinical atherosclerosis by evaluating carotid plaque including cIMT and carotid plaque features in general population. Methods and results Among 1,209 participants with no prior coronary artery disease who received a medical check-up with cardiovascular examination at our institution, 450 participants (37.2%) were smokers (including both past and current smokers). We defined carotid plaque as cIMT ≥1.1 mm and high-risk plaque as carotid plaque with hypoechoic dominant and/or plaque ulceration. The value of cIMT and the rate of carotid plaque were not different between smokers and never smokers (Figure A & B). However, the rate of carotid high-risk plaque was significantly higher in participants with smokers than those with never smokers (29.7%, vs 23.5%, p=0.011) (Figure C). Even after adjustment with covariates including age, gender and traditional cardiovascular risk factors, cigarette smoking was independently associated with high-risk plaque formation (odds ratio 1.384, 95% CI 1.020–1.877; p=0.037). According to the subgroup analysis classified by age, cigarette smoking was associated with not only the development of high-risk plaque but also the increased value of cIMT in the subgroup over 60 years old, whereas only the rate of high-risk plaque was higher in smokers than never smokers in the subgroup under 60 years old. Carotid plaque and smoking Conclusion The development of high-risk carotid artery plaque may precede thickening of cIMT in cigarette smokers, suggesting that the novel insight for the pathological mechanism underlying cardiovascular events and cigarette smoking.

scholarly journals Similar progression of carotid intima–media thickness in 7-year surveillance of patients with mild SLE and controls, but this progression is still promoted by dyslipidaemia, lower HDL levels, hypertension, history of lupus nephritis and a higher prednisolone usage in patients

2020 ◽  
Vol 7 (1) ◽  
pp. e000362 ◽  
Author(s):  
Sofia Ajeganova ◽  
Thomas Gustafsson ◽  
Linnea Lindberg ◽  
Ingiäld Hafström ◽  
Johan Frostegård
Keyword(s):  
Risk Factors ◽  
Lupus Nephritis ◽  
Carotid Plaque ◽  
Subclinical Atherosclerosis ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Average Dose ◽  
Media Thickness ◽  
History Of

ObjectiveTo compare progression of subclinical atherosclerosis and factors promoting it in patients with SLE and controls.MethodsConsecutive patients with SLE and age-matched, sex-matched population controls from the SLEVIC cohort were assessed at inclusion and after 7 years with standardised data collection and carotid ultrasound. Effect of risk factors on carotid intima–media thickness (cIMT) progression was examined with adjusted linear mixed models.ResultsA total of 77 patients and 74 controls, 68% and 61% of the original cohort, completed follow-up. The patients were (mean) 47 years old, 90% were women, and controls were 51 years old, 92% women. Patients had disease duration of (mean) 11 years, mild disease activity and low severity at both assessments. Baseline cIMT did not differ between the groups. An average absolute cIMT progression was 0.009 mm/year in patients and 0.011 mm/year in controls, intergroup difference p=0.9.Of factors at inclusion, dyslipidaemia, lower levels of high-density lipoprotein (HDL) and carotid plaque in patients and controls, and higher systolic blood pressure, total cholesterol:HDL and LDL:HDL ratios and triglycerides in patients were associated with cIMT progression. Of factors at follow-up, hypertension and blood lipids in patients and HDL in controls were significantly associated with cIMT progression. History of lupus nephritis and a higher average dose of prednisolone used since diagnosis were associated with cIMT progression in patients. Associations of risk factors with cIMT progression were stronger in presence of plaques.ConclusionWe observed a statistically comparable progression of cIMT in patients with mild SLE and controls over 7 years, which implies that progression of subclinical atherosclerosis in some patients with SLE could follow that of the general population. Traditional cardiovascular (CV) risk factors, history of lupus nephritis and higher use of corticosteroids promote cIMT progression in SLE. Detection of carotid plaque may add to CV risk stratification.

scholarly journals 3044Exploration of biomarkers for subclinical atherosclerosis in an African population using a proteomics chip targeted at inflammation and cardiovascular disease

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Jujic ◽  
L Malan ◽  
C Mels ◽  
P M Nilsson ◽  
M Magnusson
Keyword(s):  
Blood Pressure ◽  
Subclinical Atherosclerosis ◽  
Target Organ Damage ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Organ Damage ◽  
Target Organ ◽  
African Population ◽  
Carotid Ultrasound ◽  
North West

Abstract Introduction The evolving use of multiplex proteomic platforms provides an excellent tool for investigating associations between multiple proteins and subclinical atherosclerotic disease. In this study, we evaluated the impact of a multiplex protein panel, on carotid intima-media thickness (cIMT) as a marker of subclinical atherosclerosis. Purpose We used a multiplex proteomic platform to identify possible associations between proteins and subclinical carotid atherosclerosis as measured by carotid ultrasound in an African population. Methods In the Sympathetic Activity and Ambulatory Blood Pressure in Africans (SABPA) study, 92 proteins from the Proseek Multiplex CVD III 96×96 (Olink Bioscience, Sweden) were analyzed in 378 participants (mean age 44.7±9.6 years, 50.6% women, 10.8% with known cardiovascular disease). Carotid ultrasound was performed for measurements of the carotid intima-media thickness (cIMT, mean 0.663±0.127 mm) and calculation of cross-sectional wall area (CSWA, mean 13.5±4.4mm2), a measure of target organ damage. Possible associations between the proteins, and cIMT and CSWA, respectively, were explored using linear regression models. A two-sided Bonferroni corrected P-value of 0.05/92=5.4x10–4 was considered statistically significant in the crude analysis. Results Of 18 proteins (1 standard deviation of change of ln-transformed values) that were Bonferroni-corrected (p≤5.4x10–4) significantly associated with cIMT and/or CWAS in crude analyses, the following remained significant after further adjustment for age, sex, waist circumference, systolic blood pressure, smoking and total cholesterol: growth-differentiation factor-15 (GDF15; β 0.017, p=0.050), E-selectin (SELE; β 0.019, p=0.017), carboxypeptidase A1 (CPA1; β 0.019, p=0.019), C-C motif chemokine 15 (CCL15; β 0.031, p<0.001), chitinase-3-like protein 1 (CHI3L1; β 0.021, p=0.007), the hemoglobin scavenger receptor (CD163; β 0.021, p=0.008) and osteoprotegerin (OPG; β 0.022, p=0.004). As for target-organ damage defined by CSWA, SELE (β 0.459, p=0.018), CCL15 (β 0.398; p=0.032) and CD163 (β 0.541, p=0.005) showed multivariate adjusted significant associations. Conclusion In an African population, we could confirm five proteins (GDF15, SELE, CHI3L1, CD163 and OPG) associated with cIMT, but in addition identified two proteins (CPA1 and CCL15) with novel associations with cIMT and/or CSWA. Acknowledgement/Funding North-West University; National Research Foundation (NRF); Medical Research Council (MRC-SA); Department of Education North-West Province; ROCHE

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