Impact of Image Interpretation of Carotid Ultrasound Findings on Lipid Management in Patients With Elevated ASCVD Risk

TL;DR

Providing general practitioners with carotid ultrasound image interpretations leads to better LDL cholesterol reduction in elderly patients at high risk for heart disease.

Contribution

Demonstrates that integrating ultrasound image interpretation into routine care improves lipid management outcomes in high-risk patients.

Findings

The image interpretation group had a significantly greater LDL reduction compared to routine care.

The LDL improvement remained significant after adjusting for confounding factors.

No significant differences were found for total cholesterol, HDL, or triglycerides between groups.

Abstract

This study aimed to explore the impact of carotid ultrasound finding interpretation by general practitioners (GPs) on patients’ lipid management.

This study is an observational cohort study involving elderly patients aged ≥ 60 years with elevated risk of atherosclerotic cardiovascular disease (ASCVD). Participants were divided into two groups: image interpretation group and routine care group, and then followed for 3 months. Our primary outcome was to explore the between‐group differences in low‐density lipoprotein (LDL) changes between the two groups at baseline and after 3 months of follow‐up. Secondary outcomes included between‐group differences in changes of total cholesterol (TC), triglyceride (TG), and high‐density lipoprotein (HDL). The Generalized Estimating Equation model was used to calculate interaction p values, β coefficients, and their 95% CIs.

This study enrolled 338 participants, with 169 in the image interpretation group (age 69.6 ± 5.76 years) and 169 in the routine care group (age 71.59 ± 5.26 years). The between‐group difference in LDL change from baseline to follow‐up was statistically significant (interaction p = 0.028), with a β coefficient of −0.38 (95% CI −0.71, −0.04), indicating that the image interpretation group had a 0.38 mmol/L greater LDL reduction than the routine care group. This remained significant after adjusting for confounders (interaction p = 0.025, β = −0.38, 95% CI −0.70, −0.05). There were no significant between‐group differences observed against changes in TC, HDL, and TG.

This study indicated that adding image interpretation of carotid ultrasound results to routine care by GPs significantly improves lipid management in elderly patients with elevated ASCVD risk.

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