Predictor of Advanced Sub-Clinical Atherosclerosis (PASA) Study

University of Wisconsin, Madison600 enrolled

Overview

The study will evaluate the clinical utilization of skin Cholesterol (SC) for cardiovascular risk assessment in asymptomatic individuals at low, intermediate and high risk based on Framingham global risk estimates. Preliminary studies have suggested that SC is an easy to measure, noninvasive marker of cardiovascular risk. This study is intended to provide further data in support of broader clearance by the Food and Drug Administration for the use of SC as a tool to identify asymptomatic patients at increased risk of cardiovascular disease. Currently, SC testing is cleared for use as part of risk assessment in subject suspected of having significant multi-vessel disease. The current study data will be used to support the use of SC testing as part of cardiovascular risk assessment in subjects without suspected coronary artery disease (CAD).

* The primary objective of the study will be to determine the relationship between skin cholesterol levels and carotid artery intima-media thickness (CIMT), a surrogate marker for atherosclerotic burden used as the "gold standard" comparator. * Secondary objectives of the study will be to compare the skin cholesterol levels with other markers of CAD as HDL cholesterol, Apo B, hsCRP, and lipoprotein-association phospholipase A2. * Another objective is to determine the relationship between skin cholesterol levels and the presence of carotid plaques detected by ultrasound.

Study Type

INTERVENTIONAL

Allocation

NON_RANDOMIZED

Purpose

DIAGNOSTIC

Masking

NONE

Enrollment

600

Conditions

Atherosclerosis

Eligibility

Sex: ALLMin age: 30 YearsMax age: 80 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Informed written consent from the subject prior to testing. * Males or females 30-80 years of age Exclusion Criteria: * 1\. Known coronary heart disease, (history of myocardial infarction, coronary bypass surgery, coronary angioplasty, or angina pectoris with a positive stress test or angiographic documentation) * Known peripheral vascular disease (claudication with ankle-brachial index \< 0.9, angioplasty, or peripheral artery bypass procedure) * Known cerebrovascular disease (stroke or TIA with documented carotid or aortic atherosclerosis) * History of carotid artery endarterectomy or carotid artery surgery * Diabetes mellitus (fasting glucose \> 126 mg/dL, on on insulin-reducing medications) * 10-year Framingham risk of cardiac death or MI using ATP III calculator \>20% * Subjects taking cholesterol-lowering medications * Known hepatitis * Known pregnancy * Skin disease on either hand (e.g. eczema psoriasis, rash or broken skin)

Outcomes

Primary Outcomes

The primary analysis will test if SC is a predictor of elevated CIMT (i.e. carotid wall thickness above the 75% percentile expected for subject's age sex and race based on projections from the Atherosclerosis Risk in Communities Study)

Secondary Outcomes

Secondarily, estimates of relative risk will allow the comparison of the power of SC as a predictor and traditional risk and new emerging risk factors(hsCRP, Apo B100 and Phospholipase A2).