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Peer-reviewedCC BY 4.0Journal of Clinical Medicine

Beyond SCORE2: Subclinical Carotid Atherosclerosis and Associated Inflammatory, Metabolic and Renal Markers

  • Cerasela Mihaela Goidescu1,2
  • Anca Daniela Farcaş1,3
  • Iulian Gabriel Goidescu4
  • Camelia Larisa Vonica5
  • Mirela Anca Stoia1,3
  • Florin Petru Anton1,3
5 affiliations
  1. 1Internal Medicine Department, “Iuliu Haţieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
  2. 2“Constantin Papilian” Military Emergency Clinical Hospital, 400132 Cluj-Napoca, Romania
  3. 3Cardiology Department, Cluj County Emergency Clinical Hospital, 400347 Cluj-Napoca, Romania
  4. 4Obstetrics and Gynecology I, Mother and Child Department, “Iuliu Haţieganu” University of Medicine and Pharmacy, 400347 Cluj-Napoca, Romania
  5. 5Diabetes Center, Emergency Clinical County Hospital Cluj, 400006 Cluj-Napoca, Romania
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Abstract

Background: Conventional cardiovascular risk scores may not fully reflect the individual burden of subclinical atherosclerosis. We investigated the clinical and biochemical determinants of carotid plaque and assessed whether inflammatory, metabolic, and renal markers provide information beyond SCORE2. Methods: This observational study included 542 asymptomatic middle-aged adults without known atherosclerotic cardiovascular disease who underwent clinical evaluation, laboratory testing, SCORE2 estimation, and standardized carotid ultrasonography. Multivariable logistic regression was used to identify independent predictors of carotid plaque. The incremental contribution of renal function and SCORE2 was also evaluated. Results: In the primary model, older age, male sex, higher serum uric acid, and higher C-reactive protein (CRP) concentrations were independently associated with carotid plaque. Each 1 mg/dL increase in uric acid was associated with a 32.3% increase in plaque odds. After adding estimated glomerular filtration rate (eGFR), lower eGFR remained independently associated with plaque, whereas the uric acid association was attenuated. CRP and male sex remained significant. Serum uric acid correlated inversely with eGFR. In participants with complete biochemical data, uric acid, CRP, and eGFR remained independent predictors, whereas HbA1c and SCORE2 did not add significant predictive value. Conclusions: Carotid plaque was independently associated with inflammatory status, uric acid metabolism, renal function, and sex. Integrating CRP, uric acid, and eGFR with conventional risk assessment may improve detection of hidden subclinical vascular disease. A more integrated approach to cardiovascular risk assessment that incorporates inflammatory, metabolic and renal parameters could be used to improve identification of individuals with subclinical carotid vascular disease, rather than SCORE2 alone.

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Cite

BibTeXRIS
BibTeX
@article{goidescu2026beyond,
  title = {{Beyond SCORE2: Subclinical Carotid Atherosclerosis and Associated Inflammatory, Metabolic and Renal Markers}},
  author = {Cerasela Mihaela Goidescu and Anca Daniela Farcaş and Iulian Gabriel Goidescu and Camelia Larisa Vonica and Mirela Anca Stoia and Florin Petru Anton},
  journal = {Journal of Clinical Medicine},
  year = {2026},
  month = oct,
  doi = {10.3390/jcm15208132},
  url = {https://www.mdpi.com/2077-0383/15/20/8132},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Beyond SCORE2: Subclinical Carotid Atherosclerosis and Associated Inflammatory, Metabolic and Renal Markers
AU  - Cerasela Mihaela Goidescu
AU  - Anca Daniela Farcaş
AU  - Iulian Gabriel Goidescu
AU  - Camelia Larisa Vonica
AU  - Mirela Anca Stoia
AU  - Florin Petru Anton
PY  - 2026
DA  - 2026/10/01
JO  - Journal of Clinical Medicine
DO  - 10.3390/jcm15208132
UR  - https://www.mdpi.com/2077-0383/15/20/8132
AB  - Background: Conventional cardiovascular risk scores may not fully reflect the individual burden of subclinical atherosclerosis. We investigated the clinical and biochemical determinants of carotid plaque and assessed whether inflammatory, metabolic, and renal markers provide information beyond SCORE2. Methods: This observational study included 542 asymptomatic middle-aged adults without known atherosclerotic cardiovascular disease who underwent clinical evaluation, laboratory testing, SCORE2 estimation, and standardized carotid ultrasonography. Multivariable logistic regression was used to identify independent predictors of carotid plaque. The incremental contribution of renal function and SCORE2 was also evaluated. Results: In the primary model, older age, male sex, higher serum uric acid, and higher C-reactive protein (CRP) concentrations were independently associated with carotid plaque. Each 1 mg/dL increase in uric acid was associated with a 32.3% increase in plaque odds. After adding estimated glomerular filtration rate (eGFR), lower eGFR remained independently associated with plaque, whereas the uric acid association was attenuated. CRP and male sex remained significant. Serum uric acid correlated inversely with eGFR. In participants with complete biochemical data, uric acid, CRP, and eGFR remained independent predictors, whereas HbA1c and SCORE2 did not add significant predictive value. Conclusions: Carotid plaque was independently associated with inflammatory status, uric acid metabolism, renal function, and sex. Integrating CRP, uric acid, and eGFR with conventional risk assessment may improve detection of hidden subclinical vascular disease. A more integrated approach to cardiovascular risk assessment that incorporates inflammatory, metabolic and renal parameters could be used to improve identification of individuals with subclinical carotid vascular disease, rather than SCORE2 alone.
SN  - 2077-0383
ER  -