en
Scientific article
Open access
English

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

Published inArchives of internal medicine, vol. 172, no. 4, p. 344-352
Publication date2012-02-27
First online date2012-01-23
Abstract

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.

eng
Keywords
  • Adult
  • Aged
  • Blood Pressure
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / metabolism
  • Cardiovascular Diseases / physiopathology
  • Cardiovascular Diseases / psychology
  • Counseling / methods
  • Female
  • Humans
  • Lipoproteins, LDL / metabolism
  • Male
  • Middle Aged
  • Outcome and Process Assessment, Health Care
  • Plaque, Atherosclerotic / diagnostic imaging
  • Risk Factors
  • Smoking / physiopathology
  • Smoking / psychology
  • Smoking / therapy
  • Smoking Cessation / methods
  • Smoking Cessation / psychology
  • Tobacco Use Cessation Devices
  • Treatment Outcome
  • Ultrasonography
Affiliation Not a UNIGE publication
Research group
Funding
  • Swiss National Science Foundation - Impact of carotid plaque screening on smoking cessation and control of other cardiovascular risk factors: A randomized controlled trial
  • Swiss Heart Foundation -
  • Federal Office of Public Health - Swiss Tobacco Prevention Funds [FPT 08.002282]
Citation (ISO format)
RODONDI, Nicolas et al. Impact of carotid plaque screening on smoking cessation and other cardiovascular risk factors: a randomized controlled trial. In: Archives of internal medicine, 2012, vol. 172, n° 4, p. 344–352. doi: 10.1001/archinternmed.2011.1326
Main files (1)
Article (Published version)
accessLevelPublic
Identifiers
ISSN of the journal0003-9926
60views
30downloads

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