Reduced progression of carotid intima media thickness by personalised pictorial presentation of subclinical atherosclerosis in VIPVIZA—A randomised controlled trial

IF 1.3 4区医学 Q4 PHYSIOLOGY Clinical Physiology and Functional Imaging Pub Date : 2023-01-15 DOI:10.1111/cpf.12811

Emma Nyman, Christer Grönlund, Davide Vanoli, Per Liv, Margareta Norberg, Anna Bengtsson, Patrik Wennberg, Per Wester, Ulf Näslund, for the VIPVIZA trial group

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Abstract

Objectives

Reduced progression of atherosclerosis can decrease the risk of cardiovascular disease (CVD). This study aimed at evaluating the effect of a pictorial intervention showing atherosclerotic severity on the progression of carotid atherosclerosis.

Methods

A prospective randomised open-label blinded end-point trial with participants aged 40–60 years enroled from a routine CVD prevention programme. The intervention group (n: 1575) and their treating physicians received an image based presentation of subclinical atherosclerotic severity measured by carotid ultrasound. The control group (n: 1579) did not receive any information about ultrasound results. Carotid ultrasound at baseline and at 3-year follow-up contained plaque detection and measurements of carotid intima media thickness (cIMT). The left, right and bilateral-mean-cIMT, plaque prevalence and total plaque area (TPA) at 3-year follow-up were compared between groups. Significance level was set to p = 0.01 to adjust for multiple comparisons.

Results

The intervention group revealed reduced cIMT progression in the left-mean-cIMT of −0.011 mm (p = 0.001) compared with the control group. The intervention effect on cIMT progression was most prominent in individuals with increased cIMT and plaque prevalence at baseline (−0.021 mm, p = 0.005). There were no differences in progression between groups for the right-and bilateral-mean-cIMT (−0.005 mm, p = 0.223 and −0.005 mm, p = 0.036, respectively), nor any differences between groups for plaque prevalence or TPA (odds ratio 0.88, p = 0.09 and 0.89, p = 0.21, respectively).

Conclusion

Pictorial presentation of subclinical atherosclerotic severity sent to both the individual and their treating physician resulted in significantly reduced left cIMT progression. Pictorial presentation has the potential to increase adherence in CVD prevention.

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在VIPVIZA-A随机对照试验中，通过亚临床动脉粥样硬化的个性化图像表现减少颈动脉内膜中膜厚度的进展

目的减少动脉粥样硬化的进展可以降低心血管疾病(CVD)的风险。本研究旨在评估图像干预显示动脉粥样硬化严重程度对颈动脉粥样硬化进展的影响。方法前瞻性随机开放标签盲法终点试验，参与者年龄40-60岁，来自常规心血管疾病预防计划。干预组(n: 1575)及其治疗医生接受了基于图像的颈动脉超声测量的亚临床动脉粥样硬化严重程度。对照组(n: 1579)没有收到任何关于超声结果的信息。基线和3年随访时的颈动脉超声包括斑块检测和颈动脉内膜中膜厚度(cIMT)的测量。比较两组3年随访时左、右、双侧平均cimt、斑块患病率和总斑块面积(TPA)。显著性水平设为p = 0.01以调整多重比较。结果干预组与对照组相比，左平均cIMT进展减少- 0.011 mm (p = 0.001)。干预对cIMT进展的影响在基线时cIMT和斑块患病率增加的个体中最为突出(- 0.021 mm, p = 0.005)。右侧和双侧平均cimt组间无进展差异(分别为- 0.005 mm, p = 0.223和- 0.005 mm, p = 0.036)，斑块患病率和TPA组间无差异(比值比分别为0.88,p = 0.09和0.89,p = 0.21)。结论:将亚临床动脉粥样硬化严重程度的图像呈现给患者及其治疗医生，可显著降低左cIMT的进展。图片展示有可能增加心血管疾病预防的依从性。

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来源期刊

Clinical Physiology and Functional Imaging 医学-生理学

CiteScore

3.40

自引率

5.60%

发文量

审稿时长

6-12 weeks

期刊介绍： Clinical Physiology and Functional Imaging publishes reports on clinical and experimental research pertinent to human physiology in health and disease. The scope of the Journal is very broad, covering all aspects of the regulatory system in the cardiovascular, renal and pulmonary systems with special emphasis on methodological aspects. The focus for the journal is, however, work that has potential clinical relevance. The Journal also features review articles on recent front-line research within these fields of interest. Covered by the major abstracting services including Current Contents and Science Citation Index, Clinical Physiology and Functional Imaging plays an important role in providing effective and productive communication among clinical physiologists world-wide.