Hypoechoic plaque at US of the carotid artery: An independent risk factor for incident stroke in adults aged 65 years or older
Hypoechoic plaque at US of the carotid artery: An independent risk factor for incident stroke in adults aged 65 years or older
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DOI：
10.1148/radiology.208.3.9722841
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发表时间：
1998-09-01
期刊：
影响因子：
19.7
通讯作者：
Reid, C
中科院分区：
文献类型：
--
作者：
Polak, JF;Shemanski, L;Reid, C
目得：调查事件（第一次）中风和回声的颈内动脉斑块超声（US）之间的关联。材料和方法：一个队列的4,886人，在基线，年龄为65岁或以上，没有脑血管疾病的症状，平均随访3.3年。基线临床结果来自颈动脉的彩色多普勒和双功超声研究以及传统风险年龄、性别、糖尿病的存在、吸烟包年数、高血压的存在、收缩压和舒张压升高、低密度脂蛋白胆固醇水平升高的记录。在104名（2.1%）有中风风险的人中发现了中风事件，不包括出血性中风和心源性中风。经年龄和性别校正的卒中事件的比值比在低回声斑块中具有显著性（比值比，2.53; 95%CI，1.42，4.53）。在考克斯比例风险模型中控制风险因素后，低回声斑块和颈内动脉狭窄至少50%的卒中事件相对危险度（RR）分别为1.72（P = 0.015）和2.32（P = 0.004）。此外，低回声斑块（RR，2.78; CI，1.36，5.69）和50%-100%狭窄（RR，3.08; CI，1.28，7.41）与同侧非致命性卒中相关。结论：在年龄≥ 65岁的无症状成年人中，卒中事件的风险与两个US特征相关：低回声颈内动脉斑块，估计颈内动脉狭窄50%-100%。
PURPOSE: To investigate the association between incident (first) stroke and the echogenicity of internal carotid arterial plaque at ultrasonography (US).MATERIALS AND METHODS: A cohort of 4,886 individuals who, at baseline, were 65 years of age or older and without symptoms of cerebrovascular disease was followed up for an average of 3.3 years. Baseline clinical findings were from color Doppler and duplex US studies of the carotid arteries and a record of traditional risk age, sex, presence of diabetes mellitus, pack-years of cigarette smoking, presence of hypertension, elevated systolic and diastolic blood pressures, elevated low-density lipoprotein cholesterol level.RESULTS: incident strokes, excluding hemorrhagic strokes and strokes of cardiac origin, were seen in 104 individuals (2.1%) at risk. Age- and sex-adjusted odds ratios for incident stroke were significant for hypoechoic plaque (odds ratio, 2.53; 95% CI, 1.42, 4.53). After controlling for risk factors in a Cox proportional hazards model, the relative risk (RR) of incident stroke was 1.72 (P = .015) for hypoechoic plaque and 2.32 (P = .004) for internal carotid arterial narrowing of at least 50%. In addition, hypoechoic plaque (RR, 2.78; CI, 1.36, 5.69) and 50%-100% stenosis (RR, 3.08; CI, 1.28,,7.41)were associated with ipsilateral, nonfatal stroke.CONCLUSION: In asymptomatic adults aged 65 years or older, the risk of incident stroke was associated with two US features: hypoechoic internal carotid arterial plaque and an estimated internal carotid arterial stenosis of 50%-100%.