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Ultrasound Used To Predict Risk of Heart Attack

By MedImaging International staff writers
Posted on 13 Oct 2008

Repeat exams using widely available and inexpensive ultrasound imaging could help identify patients at high risk for a heart attack or other adverse cardiovascular events, according to recent research.

Researchers, who published their findings in the September 2008 issue of the journal Radiology, performed ultrasound imaging on the carotid arteries of 1,268 patients who were asymptomatic but at high risk for cardiovascular disease. Of those, ultrasound determined that 574 patients had carotid artery disease, as determined by the amount of plaque built up in the two vessels that supply blood to the head and neck. Each of those patients had a second ultrasound exam six to nine months later to measure changes in the plaque lining the arteries.

"Determining the degree of stenosis, or how much the artery has narrowed, is insufficient to predict patient risk,” said lead researcher Markus Reiter, M.D., from the department of angiography and interventional radiology at the Medical University Vienna (Austria). "We know that the majority of cardiovascular and cerebrovascular events occur in patients whose blood vessels are less than 70% narrowed.”

Dr. Reiter and his team utilized ultrasound images and computer-assisted gray scale median (GSM) measurements to determine the density of the plaque lining the carotid arteries. Plaques that appear dark on ultrasound images and have a low GSM level are suggested to be tied to an increased risk for clinical complications and they seem to represent unstable plaques, which are more likely to rupture or burst.

The study's follow-up ultrasound scans revealed that GSM levels had decreased in 230 (40%) of the patients. Of those, 85 (37%) experienced a major adverse cardiovascular event within three years of the second ultrasound. Examples of these events include heart attack, coronary artery bypass, stroke, and surgery. In 344 (60%) of the patients, ultrasound GSM levels had increased between the baseline and follow-up ultrasound examinations. Of those patients, 92 (28%) experienced a major adverse cardiovascular event.

"Patients with a reduction in GSM levels from their baseline ultrasound to the follow-up ultrasound exhibited a significantly increased risk for near-future adverse event compared to patients with increasing GSM levels,” said Dr. Reiter.

It is important to note that the results demonstrated that vulnerable plaque in the carotid artery was not only an indicator of increased risk of stroke downstream from the carotid artery, but also was associated with disease progression elsewhere in the cardiovascular system. Although additional research is needed, according to Dr. Reiter, measuring GSM levels on serial ultrasound scans, may be a noninvasive way to identify the presence of susceptible plaques and improve the success of therapeutic strategies. "This technique will give us additional information to use in selecting patients that need aggressive treatment,” he said.

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61 (!!!!! 8666.0385131836): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294720634 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294720634 AND published='1' LIMIT 1

62 (113.96408081055): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294720634 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294720634 AND published='1' LIMIT 1

63 (576.01928710938): select cover from jos_number where journalid in (5) and cover is not null order by left(issue,2)+right(issue,2)*12 desc limit 1

64 (807.04689025879): SELECT fid FROM jos_deeppockets WHERE id=294720634 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294720634 AND published='1' LIMIT 1

65 (46.968460083008): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=214 ORDER BY `ordering`

66 (641.1075592041): select jos_twitters.link from jos_twitters where cat=10

67 (88.930130004883): select jos_facebook.link from jos_facebook where cat=10

68 (129.93812561035): select jos_google_plus.link from jos_google_plus where cat=10

69 (190.97328186035): select jos_linkedin.link from jos_linkedin where cat=10

70 (!!!!! 1712.0838165283): SELECT fid FROM jos_deeppockets WHERE id=294720634 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294720634 AND published='1' LIMIT 1

71 (64.849853515625): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=214 ORDER BY `ordering`

72 (!!!!! 2517.9386138916): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294720634 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

73 (534.0576171875): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294720634 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

74 (81.062316894531): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

75 (!!!!! 3334.9990844727): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (416.04042053223): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (370.02563476562): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (504.0168762207): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (651.83639526367): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (179.05235290527): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (624.8950958252): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (374.07875061035): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (521.89826965332): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (38.862228393555): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (293.97010803223): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (364.06517028809): SELECT show_live FROM jos_com_show_setting LIMIT 1

88 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

89 (!!!!! 1133.918762207): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294720634 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

90 (294.92378234863): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294720634 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

91 (38.14697265625): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

92 (!!!!! 2187.967300415): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (60.081481933594): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (216.96090698242): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (334.9781036377): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (!!!!! 4734.0393066406): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (611.0668182373): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (659.94262695312): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (56.028366088867): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (39.100646972656): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (458.95576477051): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (41.961669921875): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (!!!!! 1213.0737304688): SELECT show_live FROM jos_com_show_setting LIMIT 1

105 (72.956085205078): SELECT show_live FROM jos_com_show_setting LIMIT 1

106 (!!!!! 2129.077911377): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294720634 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294720634 AND published='1' LIMIT 1

107 (458.0020904541): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294720634 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294720634 AND published='1' LIMIT 1

108 (!!!!! 1286.0298156738): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294720634 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

109 (545.97854614258): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294720634 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

110 (!!!!! 5284.7862243652): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294720634 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294720634 AND published='1' LIMIT 1

111 (264.16778564453): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294720634 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294720634 AND published='1' LIMIT 1

112 (!!!!! 1124.8588562012): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294720634 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

113 (609.15946960449): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294720634 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

114 (816.10679626465): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

115 (505.92422485352): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

116 (129.93812561035): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294720634 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294720634 AND published='1' LIMIT 1

117 (57.93571472168): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294720634 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294720634 AND published='1' LIMIT 1

118 (94.890594482422): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294720634 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294720634 AND published='1' LIMIT 1

119 (61.988830566406): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294720634 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294720634 AND published='1' LIMIT 1

120 (46.968460083008): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294720634 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294720634 AND published='1' LIMIT 1

121 (51.021575927734): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294720634 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294720634 AND published='1' LIMIT 1

122 (109.91096496582): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294720634 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294720634 AND published='1' LIMIT 1

123 (63.896179199219): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294720634 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294720634 AND published='1' LIMIT 1

124 (375.98609924316): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

125 (!!!!! 110769.98710632): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

126 (606.06002807617): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294720634 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294720634 AND type='deeppockets_item' AND published='1' LIMIT 1

127 (!!!!! 50693.988800049): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

128 (104.90417480469): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

129 (!!!!! 4024.0287780762): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

130 (46.968460083008): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

131 (41.961669921875): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

132 (27.894973754883): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

133 (375.98609924316): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

134 (62.942504882812): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

135 (35.04753112793): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

136 (28.133392333984): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

137 (375.03242492676): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294720634 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

138 (274.8966217041): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294720634 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

139 (41.007995605469): SELECT name FROM jos_deeppockets WHERE id=214

140 (28.848648071289): SELECT name FROM jos_deeppockets WHERE id=214

141 (633.00132751465): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))214((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

142 (566.95938110352): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))214((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

143 (69.856643676758): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294720634 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294720634 AND published='1' LIMIT 1

144 (50.067901611328): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294720634 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294720634 AND published='1' LIMIT 1

145 (!!!!! 7792.9496765137): TRUNCATE TABLE jos_trademed_module

146 (!!!!! 2918.9586639404): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294720634 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

147 (128.98445129395): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294720634 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

148 (500.20217895508): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294720634 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

149 (61.988830566406): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294720634 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

150 (56.982040405273): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294720634 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294720634 AND published='1' LIMIT 1

151 (40.054321289062): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294720634 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294720634 AND published='1' LIMIT 1

152 (!!!!! 1528.9783477783): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

153 (!!!!! 4746.9139099121): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294720634 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294720634 AND published='1' LIMIT 1

154 (316.85829162598): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294720634 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294720634 AND published='1' LIMIT 1

155 (!!!!! 3414.1540527344): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294720634 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294720634 AND type='deeppockets_item' AND published='1' LIMIT 1

156 (47.206878662109): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=214 or channel_id is null)

157 (30.994415283203): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=214 or channel_id is null)

158 (88.930130004883): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

159 (164.98565673828): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294720634 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294720634 AND published='1' LIMIT 1

160 (52.213668823242): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294720634 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294720634 AND published='1' LIMIT 1

161 (66.995620727539): select jos_twitters.link from jos_twitters where cat=10

162 (52.928924560547): select jos_facebook.link from jos_facebook where cat=10

163 (40.054321289062): select jos_google_plus.link from jos_google_plus where cat=10

164 (28.848648071289): select jos_linkedin.link from jos_linkedin where cat=10

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