The association between endothelial dysfunction and cardiovascular outcomes in a population-based multi-ethnic cohort
The association between endothelial dysfunction and cardiovascular outcomes in a population-based multi-ethnic cohort
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DOI：
10.1016/j.atherosclerosis.2006.05.005
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发表时间：
2007-05-01
期刊：
影响因子：
5.3
通讯作者：
Homma, Shunichi
中科院分区：
文献类型：
--
作者：
Shimbo, Daichi;Grahame-Clarke, Cairistine;Homma, Shunichi
背景：肱动脉血流介导扩张（FMD）可以预测特定高危患者的心血管事件。口蹄疫检测是否能预测普通人群中无症状、低风险个体的心血管事件尚不清楚。方法和结果：作为一项多种族、前瞻性队列研究——北曼哈顿研究的一部分，我们通过高分辨率超声检查了842名没有中风或心肌梗死的社区参与者的口蹄疫。较低的FMD水平预测了36个月随访时的心血管事件（心肌梗死、中风和血管性死亡）（FMD每降低1%，风险比(HR) = 1.12, 95% CI 1.01-1.25, p = 0.03）。低两分位数（FMD < 7.5%）的FMD患者发生事件的风险显著高于高分位数（最低分位数vs最高分位数的HR = 3.28, 95% CI 1.07-10.06, p = 0.04；中分位数vs最高分位数的HR = 3.05, 95% CI 1.03-9.66, p = 0.04）。在包括心血管危险因素的多变量分析中，与口蹄疫相关的风险增加不再具有统计学意义。结论：无创FMD检测可预测多民族人群的心血管事件，但其预测价值并非独立于心血管危险因素。2006爱思唯尔爱尔兰有限公司版权所有。
Background: Brachial artery flow-mediated dilation (FMD) may predict cardiovascular events in selected high-risk patients. Whether FMD testing predicts cardiovascular events in asymptomatic, lower risk individuals from the general population is unknown.Methods and results: As a part of a multi-ethnic, prospective cohort study, the Northern Manhattan Study, we examined FMD by high-resolution ultrasonography in 842 community participants who were free of stroke or myocardial infarction. Lower FMD levels predicted cardiovascular events (myocardial infarction, stroke and vascular death) at 36 months of follow-up (hazard ratio (HR) = 1.12 for every 1% decrease in FMD, 95% CI 1.01-1.25, p = 0.03). The risk of events in patients with FMD in the lower two tertiles (FMD < 7.5%) was significantly higher than those in the highest tertile (HR = 3.28, 95% CI 1.07-10.06, p = 0.04 for lowest versus highest tertile, and HR = 3.05, 95% CI 1.03-9.66, p = 0.04 for middle versus highest tertile). In a multivariate analysis including cardiovascular risk factors, the increase in risk associated with FMD was no longer statistically significant.Conclusions: Non-invasive FMD testing predicts incident cardiovascular events in this multi-ethnic, population-based sample, but its predictive value is not independent of cardiovascular risk factors. (c) 2006 Elsevier Ireland Ltd. All rights reserved.