Improving residual risk stratification of cardiovascular events using carotid ultrasonography.
Improving residual risk stratification of cardiovascular events using carotid ultrasonography.
复制标题
使用颈动脉超声检查改善心血管事件的残余风险分层。
DOI：
10.1093/eurjpc/zwac141
复制
发表时间：
2022
影响因子：
8.3
通讯作者：
The,Erlinda
中科院分区：
文献类型：
--
作者：
The,Erlinda
动脉粥样硬化是一种慢性进行性疾病，其特征是动脉内膜中的脂质积聚、巨噬细胞浸润和过度纤维斑块。1动脉粥样硬化性心血管疾病（ASCVD）是全球主要的死亡原因。2在西方社会，ASCVD约占全因死亡率的50%。ASCVD增加了美国和欧洲医疗保健系统的负担，估计这些社会分别花费了3634亿美元和2216亿美元。3-5危险分层对于ASCVD患者的治疗策略的优化至关重要。颈动脉超声检查在筛查ASCVD方面具有优势，因为它成本低，无创，并且可以重复成像。此外，颈动脉超声检查可以通过测量颈动脉内膜中层厚度（CIMT）和颈动脉斑块的成熟成像标记物来量化动脉粥样硬化。7颈动脉内膜厚度的变化与亚临床动脉粥样硬化相关。8，9超声测量内膜-中层厚度被认为是高度准确的，与组织病理学检查相当。10颈动脉斑块是ASCVD的另一个预测因素。11，12根据美国超声心动图学会的指南，颈动脉斑块或CIMT值大于或等于第75百分位数被认为是异常的。CIMT的测量和颈动脉斑块的识别对于ASCVD风险分层的细化至关重要。
Atherosclerosis is a chronic and progressive disease characterized by lipid accumulation, macrophage infiltration, and excessive fibrous plaques in arterial intima. 1 Atherosclerotic cardiovascular disease (ASCVD) is a leading cause of death worldwide. 2 In western societies, ASCVD accounts for approximately 50% of all-cause mortality. ASCVD has increased the burden of healthcare systems in the United States and in Europe, costing these societies an estimated $363.4 billion and $221.6 billion, respectively. 3–5 Risk stratification is crucial in the optimization of treatment strategies for ASCVD patients.Carotid ultrasonography is advantageous in screening ASCVD, given that it is low-cost, non-invasive, and allows for reproducible imaging. 6 Additionally, carotid ultrasonography can quantify atherosclerosis by measuring the well-established imaging markers of carotid intima-media thickness (CIMT) and carotid plaque. 7 The change in the carotid intima thickness is associated with subclinical atherosclerosis. 8, 9 Ultrasonographic measurements of intima-media thickness are viewed as highly accurate and are equivalent to histopathological examination. 10 Carotid artery plaque is an additional predictive factor for ASCVD. 11, 12 The presence of carotid plaques or a CIMT value greater than or equal than the 75th percentile are considered abnormal, based on guidelines from the American Society of Echocardiography. 13 The measurement of CIMT and identification of carotid plaque are essential in the refinement of ASCVD risk stratification.