Impact of carotid plaque screening on smoking cessation and other cardiovascular risk factors: a randomized controlled trial.


Autoria(s): Rodondi Nicolas; Collet Tinh-Hai; Nanchen David; Locatelli Isabella; Depairon Michèle; Aujesky Drahomir; Bovet Pascal; Cornuz Jacques
Data(s)

01/02/2012

Resumo

BACKGROUND: Screening of peripheral atherosclerosis is increasingly used, but few trials have examined its clinical impact. We aimed to assess whether carotid plaque screening helps smokers to improve their health behaviors and cardiovascular risk factors. METHODS: We randomly assigned 536 smokers aged 40 to 70 years to carotid plaque ultrasonographic screening (US group) vs no screening (control group) in addition to individual counseling and nicotine replacement therapy for all participants. Smokers with at least 1 plaque received pictures of their plaques with a 7-minute structured explanation. The outcomes included biochemically validated smoking cessation at 12 months (primary outcome) and changes in cardiovascular risk factor levels and Framingham risk score. RESULTS: At baseline, participants (mean age, 51.1 years; 45.0% women) smoked an average of 20 cigarettes per day with a median duration of 32 years. The US group had a high prevalence of carotid plaques (57.9%). At 12 months, smoking cessation rates were high, but did not differ between the US and control groups (24.9% vs 22.1%; P = .45). In the US group, cessation rates did not differ according to the presence or absence of plaques. Control of cardiovascular risk factors (ie, blood pressure and low-density lipoprotein cholesterol and hemoglobin A(1c) levels in diabetic patients) and mean absolute risk change in Framingham risk score did not differ between the groups. The mean absolute risk change in Framingham risk score was +0.6 in the US group vs +0.3 in the control group (P = .56). CONCLUSION: In smokers, carotid plaque screening performed in addition to thorough smoking cessation counseling is not associated with increased rates of smoking cessation or control of cardiovascular risk factors. Trial Registration  clinicaltrials.gov Identifier: NCT00548665.

Identificador

https://serval.unil.ch/?id=serval:BIB_0518CEF1C9FF

isbn:0003-9926

pmid:22269590

doi:10.1001/archinternmed.2011.1326

isiid:000300739500010

Idioma(s)

en

Direitos

info:eu-repo/semantics/openAccess

Fonte

Archives of Internal Medicine, vol. 172, no. 4, pp. 344-352

Tipo

info:eu-repo/semantics/article

article