Predictive value for cardiovascular events of common carotid intima media thickness and its rate of change in individuals at high cardiovascular risk - Results from the PROG-IMT collaboration
Predictive value for cardiovascular events of common carotid intima media thickness and its rate of change in individuals at high cardiovascular risk - Results from the PROG-IMT collaboration
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DOI：
10.1371/journal.pone.0191172
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发表时间：
2018-04-12
期刊：
影响因子：
3.7
通讯作者：
Thompson, Simon G.
中科院分区：
文献类型：
--
作者：
Lorenz, Matthias W.;Gao, Lu;Thompson, Simon G.
目的颈动脉内膜中层厚度(CIMT)可预测心血管事件，但CIMT变化的预测价值仍存在争议。方法和结果从31个队列中，平均相隔3.6年进行两次颈动脉内膜厚度扫描(总共n=89070)，并进行临床随访：(A)至少有3个心血管危险因素的个体没有心血管事件；(B)颈动脉斑块无心血管事件；(C)既往有心血管事件的个体。COX回归模型适用于根据CIMT变化的标准差(SD)估计合并终点(心肌梗死、中风或血管死亡)的危险比(HR)，并调整了CVD危险因素。在A、B和C组中，我们分别观察到3483、2845和1165个终点事件。普通CIMT年变化量(0.02~0.43 mm)A组为0.99(95%可信区间：0.95~1.02)，B组为0.98(0.93~1.04)，C组为0.95(0.89~1.04)。0.09~0.75 mm)，A组为1.15(1.07~1.23)，B组为1.13(1.05~1.22)，C组为1.12(1.05~1.20)。CIMT改变与高危个体的未来事件风险无关。
AimsCarotid intima media thickness (CIMT) predicts cardiovascular (CVD) events, but the predictive value of CIMT change is debated. We assessed the relation between CIMT change and events in individuals at high cardiovascular risk.Methods and resultsFrom 31 cohorts with two CIMT scans (total n = 89070) on average 3.6 years apart and clinical follow-up, subcohorts were drawn: (A) individuals with at least 3 cardiovascular risk factors without previous CVD events, (B) individuals with carotid plaques without previous CVD events, and (C) individuals with previous CVD events. Cox regression models were fit to estimate the hazard ratio (HR) of the combined endpoint (myocardial infarction, stroke or vascular death) per standard deviation (SD) of CIMT change, adjusted for CVD risk factors. These HRs were pooled across studies.In groups A, B and C we observed 3483, 2845 and 1165 endpoint events, respectively. Average common CIMT was 0.79mm (SD 0.16mm), and annual common CIMT change was 0.01mm (SD 0.07mm), both in group A. The pooled HR per SD of annual common CIMT change (0.02 to 0.43mm) was 0.99 (95% confidence interval: 0.95-1.02) in group A, 0.98 (0.93-1.04) in group B, and 0.95 (0.89-1.04) in group C. The HR per SD of common CIMT (average of the first and the second CIMT scan, 0.09 to 0.75mm) was 1.15 (1.07-1.23) in group A, 1.13 (1.05-1.22) in group B, and 1.12 (1.05-1.20) in group C.ConclusionsWe confirm that common CIMT is associated with future CVD events in individuals at high risk. CIMT change does not relate to future event risk in high-risk individuals.