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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We read with great interest the article &#8220;Cardiovascular risk factors and carotid intima-media thickness in a Colombian population with psoriasis&#8221; by A&#46; Argote et al&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> The authors of the article report on the prevalence of cardiovascular risk factors&#44; metabolic syndrome&#44; and increased carotid intima-media thickness &#40;CIMT&#41; in a group of 40 patients with psoriasis with no control group&#46; In the discussion&#44; the authors indicate that increased CIMT contributes to atherosclerotic processes and the development of cardiovascular events&#46; They go on to highlight the importance of CIMT as a subclinical predictor of cardiovascular risk that could be useful for guiding treatment decisions in this setting&#46; We would like to make the following comments with respect to these statements&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">While CIMT was initially used as a biomarker for subclinical atherosclerosis&#44;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> it is now generally accepted that it is a poor predictor of cardiovascular risk and that&#44; in most cases&#44; it is not related to atherosclerosis and does not significantly increase the predictive capacity of a simple analysis of traditional cardiovascular risk factors&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a> For this reason&#44; CIMT has been eliminated from the American College of Cardiology&#47;American Heart Association Guideline&#46;<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">3&#44;4</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">We would also like to make the point that any assessment of cardiovascular risk by carotid ultrasound must take into account 2 important considerations&#46; The measurement of CIMT in an area of the carotid artery where there is no atheromatous plaque does not represent the degree of atherosclerosis&#46; However&#44; when the thickness of a plaque is included in the CIMT measurement&#44; the resulting value does relate to the degree of atherosclerosis because the simple presence of atheromatous plaque is a predictor of cardiovascular risk&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">For this reason&#44; it is accepted that the study of cardiovascular risk by carotid and&#47;or femoral ultrasound should always be based on the study of atheromatous plaque&#44; assessing one of the following&#58; the simple presence of plaque by two-dimensional &#40;2D&#41; ultrasound&#44; total plaque area by 2D ultrasound&#44; or total plaque volume by 3D ultrasound&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">In such an ultrasound assessment of cardiovascular risk&#44; it is sufficient to study the simple presence of atheromatous plaque<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a>&#59; however&#44; to monitor the progression or regression of plaque size over time or as a response to treatment&#44; changes in the total plaque area or volume must also be evaluated&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a> The drawback is that monitoring total plaque area or volume increases the complexity of the study and the time spent&#46; It must be assumed that&#44; at this time&#44; ultrasound study of CIMT does not provide reliable data as a subclinical predictor of cardiovascular risk and that&#44; in this respect&#44; it has been displaced by the ultrasound study of atheromatous plaque&#44; which involves assessing the presence of plaque and&#44; in some cases&#44; total plaque area or volume&#44; depending on the desired clinical objectives and the means available&#46;</p></span>"
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Letter to the Editor
Comment on “Cardiovascular Risk Factors and Carotid Intima-Media Thickness in a Colombian Population With Psoriasis”
Réplica a «Factores de riesgo cardiovascular y grosor de la íntima media carotídea en una población colombiana con psoriasis»
Á. González-Canteroa,
Autor para correspondencia
alvarogc261893@hotmail.com

Corresponding author.
, J. González-Canterob, A.I. Sánchez-Moyaa, C. Pérez-Horteta, C. Schoendorff-Ortegaa
a Servicio de Dermatología, Complejo Hospitalario de Toledo, Toledo, Spain
b Servicio de Radiodiagnóstico, Hospital Gregorio Marañón, Madrid, Spain
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Información del artículo
ISSN: 15782190
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