Three-Dimensional Carotid Ultrasound Plaque Texture Predicts Vascular Events

Background and Purpose—Carotid ultrasound atherosclerosis measurements, including those of the arterial walland plaque, provide a way to monitor patients at risk of vascular events. Our objective was to examine carotid ultrasound plaque texture measurements and the change in carotid plaque texture during 1 year in patients at risk of events and to compare these with measurements of plaque volume and other risk factors as predictors of vascular events. Methods—We evaluated 298 patients with carotid atherosclerosis using 3-dimensional ( 3D) ultrasoundat baseline and after 1 year and measured carotid plaque volume and 376 measures of plaque texture. Patients were followed up to 5 years (median [range], 3.12 [0.77–4.66]) for myocardial infarction, transient ischemic attack, and stroke. Sparse Cox regression was used to select the most predictive plaque texture measurements in independent training sets using a 10-fold cross-validation, repeated 5×, to ensure unbiased results. Results—Receiver operator curves ...