Mitchell C, et al. - Researchers investigated if ultrasound carotid plaque features are associated with cardiovascular disease (CVD) risk factors. They also determined the role of ultrasound carotid plaque features in predicting future CVD events. In the subjects who participated in the first (baseline) visit of the Multi-Ethnic Study of Atherosclerosis, using B-mode carotid ultrasound, total carotid plaque area (TPA) and grayscale plaque features (grayscale median, black areas, and discrete white areas) were measured. They found an association of TPA with CVD risk factors in middle-aged adults free of known cardiovascular disease, but no such association was found for grayscale plaque features. They also found that incident coronary heart disease (CHD) events were predicted by TPA but not by grayscale features. Data also revealed prediction indices for TPA were like carotid plaque score for CHD but less than for coronary artery calcium.