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IMT Scan vs. Other Factors

Published: January 1, 2009

I am active and healthy. Given my family history of heart disease, an IMT scan was recently done. Results include IMT .931 and vascular age 85 (I am 69). Both sides contain plaque. Consequently, my physician has urged me to begin a statin. I am trying to gather information related to using a statin. Any other suggestions?

An IMT ultrasonic (echo) scan, or an intima-media thickness measurement of the wall of the carotid artery in the neck, is often used as a surrogate marker for the development of atherosclerosis. When cholesterol gets deposited into arteries, the inner (intima) and middle (media) parts of the arterial wall thicken, so that a thicker wall produces a higher IMT score, which indicates the presence of increased cholesterol deposition and, therefore, more advanced atherosclerosis. What happens in the carotid artery in the neck appears to correlate with what is happening to arteries in the heart and head and, therefore, indicates a greater propensity for developing problems like a heart attack or stroke.

However, the IMT score is only one piece of an overall evaluation, and there are no studies showing that such a measurement alone improves patient outcomes. Nevertheless, given your family history and the fact that you have plaque in your carotid arteries (and assuming your lipids are abnormal), treatment with a statin would be indicated. If you were my patient, I would also address other risk factors such as diet, activity, smoking, blood pressure, weight, diabetes, and so on, and not consider a statin in isolation.

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