SonoSite, Inc. (Nasdaq:SONO), the world leader in
hand-carried ultrasound, announced today that Dr. John Postley of the
New York Physicians Group has presented results from his study
demonstrating that vascular ultrasound screening can be a more
accurate means of risk stratification for heart attack, particularly
among women, than the Framingham Risk Score, which has been the
traditional method of identifying cardiovascular risk.
Dr. Postley presented his study, "Gender Differences in the
Relationship of Ultrasound Identified Atherosclerosis to Framingham
Risk Score," on Sunday, September 3, at the World Congress of
Cardiology 2006. (The Congress is meeting at the Fira Gran Mia M2 in
Barcelona until September 6.) Dr. Postley used SonoSite hand-carried
ultrasound systems in his study, in which 120 patients from his
practice were examined with ultrasound for the presence of carotid and
femoral arterial plaque and the measurement of carotid intimal medial
thickness (CIMT).
Among the 50 women in the study, Dr. Postley found no correlation
between Framingham Risk Scoring (FRS) and the thickening of the
endothelial lining of the carotid artery, or CIMT, a well-established
surrogate for cardiovascular disease events. Further, while 72 percent
of these women were at low risk for heart attack according to FRS, 50
percent of this group had incidence of plaque. Even in the absence of
other risk factors, presence of plaque is a proven precursor to heart
attack and stroke.
Dr. Postley's poster can be viewed on SonoSite's website at
www.sonosite.com.
"Atherosclerosis, as it ultimately leads to heart attack and
stroke, is the leading cause of death in the United States and the
mortality rate associated with the first heart attack or stroke is
very high," said Dr. Postley. "Clearly, a better method for
risk-stratifying patients is needed so that preventive treatment can
begin for those who need it most. Screening for CIMT and plaque with
vascular ultrasound can uncover at-risk patients with greater accuracy
than traditional methods, and should allow for earlier intervention to
prevent the progression of disease.
"CIMT and plaque screening should be performed during the annual
physical examination, and hand-carried ultrasound is the ideal
screening tool," added Dr. Postley. "With a resolution limit of
one-tenth of a millimeter, ultrasound can detect early thickening of
the intimal medial layer that would be overlooked by CT or MR
angiography. If ultrasound was more commonly used in the physical
exam, I believe it could save hundreds of thousands of lives every
year."
"This is groundbreaking research," said Kevin M. Goodwin,
President and CEO of SonoSite. "And it underscores our belief that
CIMT measurement belongs in the physical exam, and that vascular
imaging by primary care physicians can enhance the life saving
potential of a routine doctor's visit. Dr. Postley's study should
improve the early detection and treatment of atherosclerosis and we
are delighted that our systems played such an important role."
All CIMT measurements were made with a SonoSite TITAN(R) system
and patented SonoCalc(TM) IMT automated edge detection software.
SonoCalc IMT results can be used adjunctively with other medical data
by a physician to help assess the cardiovascular health of a patient.
Dr. Postley is a member of SonoSite's IMT Advisory Board, a group of
primary care physicians, cardiologists and neurologists evaluating
carotid IMT, to enhance the physical examination and to more
effectively identify and manage patients at risk for cardiovascular
disease.
Abstract
Atherosclerosis as manifest in coronary artery disease,
cerebrovascular disease and peripheral vascular disease is the leading
cause of death in the United States. Mortality of first events,
particularly with myocardial infarction, is very high and it is urgent
that we have a method of identifying people at risk before that
initial event. The use of Common carotid intimal medial thickness
(CIMT) is well established as a surrogate for cardiovascular disease
events. The use of screening vascular ultrasound of the carotid and
femoral arteries as a surrogate of coronary atherosclerosis has been
validated by the CAFES-CAVE study. Framingham Risk Score (FRS) has
been the traditional method of identifying cardiovascular risk.
In the present study, 120 untreated and unselected patients drawn
from a university based group medical practice were evaluated by
ultrasound for the presence and type of carotid and femoral arterial
bifurcation plaque and the measurement of common carotid intimal
medial thickness (CIMT). The age range was 34 to 74 years and there
were 50 women and 70 men evaluated. Distribution of FRS was among men:
0-6, 31%; 7-12, 39%; 13-25, 30% while among women: 0-6, 72% and 7-18,
28%.
The correlation of FRS with Average CIMT was r=0.40 (p less than
0.001) for all patients and the correlation of FRS with Maximum CIMT
was r=0.40 (p less than 0.001). When CIMT measurements were divided by
gender, correlation of FRS with Average mean CIMT (r=0.49) and Maximum
CIMT (r=0.47) was highly significant (p less than 0.001) among men
while there was no correlation for Average CIMT (r=0.04, p=0.7) or for
Maximum CIMT (r=0.07, p=0.6) among women.
This gender-based divergence of the correlation of CIMT with FRS
was repeated in the assessment of arterial plaque. Among men, the
incidence of any plaque for each FRS group was: 0-6, 27%; 7-12, 59%;
13-25, 67% while among women: 0-6, 50% and 7-18, 43%.
Screening vascular ultrasound analysis produces a different
pattern of risk assessment than does traditional Framingham risk
analysis particularly in women. The use of screening vascular
ultrasound as a complement to traditional risk analysis can uncover
additional patients at risk and allow earlier intervention to prevent
disease progression.
About SonoSite
SonoSite, Inc. (www.sonosite.com) is the innovator and world
leader in hand-carried ultrasound, with an installed base of more than
25,000 systems. The company, headquartered near Seattle, is
represented by eight subsidiaries and a global distribution network in
over 75 countries. SonoSite's small, lightweight systems are expanding
the use of ultrasound across the clinical spectrum by cost-effectively
bringing high-performance ultrasound to the point of patient care. The
company employs approximately 500 people worldwide.
