A Review of Surrogate Markers for Atherosclerosis: Flow Mediated Dilatation; Carotid Intima Media Thickness; Pulse Wave Velocity; Ankle Brachial Index

Atherosclerotic disease is a major cause of morbidity and mortality. The early detection of preclinical atherosclerosis with non-invasive tools has become paramount in order to identify the vulnerable patient and provide aggressive prevention measures. A valid surrogate marker should not only be proven to correlate with underlying atherosclerosis but also needs to be accurate, reproducible and inexpensive. There are currently a number of methods that are widely used for the detection of preclinical atherosclerosis. In this review, we chose 4 methods for discussion namely, (1) Flow-mediated dilatation, (2) Carotid intima media thickness, (3) Pulse wave velocity, and, (4) Ankle brachial index. Clinical evidence concerning their detection of underlying atherosclerosis and their predictive value of cardiovascular events together with their individual drawbacks is discussed.