Common carotid intima-media thickness in cardiovascular risk stratification of older people: the Rotterdam Study
Common carotid intima-media thickness in cardiovascular risk stratification of older people: the Rotterdam Study
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DOI：
10.1177/1741826711414623
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发表时间：
2012-08-01
影响因子：
8.3
通讯作者：
Witteman, Jacqueline C. M.
中科院分区：
文献类型：
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作者：
Elias-Smale, Suzette E.;Kavousi, Maryam;Witteman, Jacqueline C. M.
目的：动脉粥样硬化的非侵入性测量，如颈动脉内膜中层厚度（cIMT），可能会改善全球心血管风险预测。本研究的目的是确定是否颈总动脉IMT除了传统的危险因素，提高风险分类在一般人群中的老年people.Methods和results：一组3580名非糖尿病患者年龄在55-75岁，无心血管疾病在基线进行了随访，中位数时间为12.2年。与基于Fragrance风险因素的模型相比，我们研究了常见cIMT测量方法更好地将人群分类为10年内严重冠心病（CHD）和中风低风险（20%）的能力。在老年男性中，将cIMT添加到脆性危险因素中并不能改善对硬CHD或卒中的预测。在老年女性中，将cIMT添加到Fracture风险因素中显著改善了风险分类。在良好的校准下，cIMT将硬CHD模型的C统计量从0.711提高到0.719，将中风模型的C统计量从0.712提高到0.721。大多数低风险女性（4%（n=76）为重度CHD，3%（n=62）为卒中）的重新分类最少，中度风险女性（43%（n=70）为重度CHD，28%（n=76）为卒中）的重新分类最多。女性的净重新分类改善为8.2%（p=0.03）为硬CHD和8.0%（p=0.06）为stroke.Conclusion：cIMT有一些额外的价值超出传统的危险因素，在老年女性的心血管危险分层，但不是老年男性。
Aim: Non-invasive measures of atherosclerosis, such as carotid intima-media thickness (cIMT), may improve global cardiovascular risk prediction. The aim of this study was to determine whether common carotid IMT in addition to traditional risk factors improves risk classification in a general population of older people.Methods and results: A group of 3580 non-diabetic people aged 55-75 years and free of cardiovascular disease at baseline were followed for a median time of 12.2 years. Compared to models based on Framingham risk factors, we studied the ability of common cIMT measurement to better classify people into categories of low (20%) 10-year risk of hard coronary heart disease (CHD) and stroke. In older men, addition of cIMT to Framingham risk factors did not improve prediction of hard CHD or stroke. In older women, addition of cIMT to Framingham risk factors significantly improved risk classification. cIMT improved the C-statistic of the model for hard CHD from 0.711 to 0.719 and for stroke from 0.712 to 0.721, at good calibration. Reclassification was least in the majority of women classified as low risk (4% (n=76) for hard CHD and 3% (n=62) for stroke) and most substantial in women at intermediate risk (43% (n=70) for hard CHD and 28% (n=76) for stroke). The net reclassification improvement in women was 8.2% (p=0.03) for hard CHD and 8.0% (p=0.06) for stroke.Conclusion: cIMT had some additional value beyond traditional risk factors in the cardiovascular risk stratification of older women, but not of older men.