The country's leading cardiologists published the Executive Summary of the Screening for Heart Attack Prevention and Education (SHAPE) Task Force Report in The American Journal of Cardiology 2006;98{suppl}:2H-15H.  SHAPE Guidelines recommend screening all men ages 45 - 75, and all women age 55 - 75 for vulnerable plaque unless they have no risk factors.
For full details please go to www.shapesociety.org


Existing Guidelines for Cardiovascular Screening are Inadequate

• Stratify patients according to the Framingham Risk Score.
• More than 80% of events occur in the low and intermediate risk groups.
• Many individuals at true high risk will not be identified, and not treated properly.
• Others, erroneously classified as high risk, will be treated unnecessarily  for the rest of their life.
• Clearly, this is neither cost-effective, nor good medical practice.

 
                New Paradigm for the Prevention of Heart Attack and Stroke

• Accurately identify the "Vulnerable" patient with an imaging study and treat aggressively.
• Stop aggressive treatment of patients with minimal disease.
• Replace traditional risk factor assessment with direct measurement of atherosclerotic plaque.  

Several methods are available to image plaque:

Carotid Intima-Media Thickness (CIMT) measurement uses B-mode ultrasound with EKG 
gating, and sophisticated edge-detection software.  Studies involving over 37,000 patients have shown a 90% correlation between the  common carotid artery IMT and coronary arteries.  CIMT does not require radiation and can be used to follow a patient's response to therapy over time as reverse cholesterol transport shrinks the fatty plaque.  

Intravasular Ultrasound (IVUS) is the gold standard but is invasive and not readily available  
   
Coronary Artery Calcium Scoring (CACS) requires radiation and a 64 slice CT Scanner. It cannot be used to follow a patient's response to therapy. Fatty plaque may thin with treatment over time but the calcium in the plaque remains 

MRI is being investigated for this purpose

COASTAL CIMT uses certified vascular technologists, state-of-the-art high frequency B-mode ultrasound equipment with EKG gating, and ArterioVision^TM sophisticated edge-detection software.  In addition to precisely measuring the inner two layers of the carotid artery where fatty plaque first develops, Arteriovision compares each result to individuals of the same age and sex in a California Institute of Technology database of 15,000 people to determine their "Artery Age" and their lifetime risk of a heart attack.  COASTAL CIMT'S certified vascular technologists also screen the patient's internal carotid arteries for the presence or absence of lumenal plaque as part of the exam.

Coastal CIMT also assesses the plaque characteristics; something not seen in Coronary Artery Calcium Score (CACS) tests.  Soft plaque is more vulnerable to rupture and can break off causing a heart attack or stroke.  Early detection allows the physician and the patients to develop treatment regimens that are your best protection to prevent a heart attack or stroke.

Screening using CIMT has been endorsed by the National Cholesterol Education Program (ATPIII), the American Heart Association, and the American College of Cardiology.

You can learn  more about ArterioVision^TM at www.i-mti.com