Carotid intima-media thickness and risk of cardiovascular events in high-risk patients - Results of the Osaka follow-up study for carotid atherosclerosis 2 (OSACA2 study)
Carotid intima-media thickness and risk of cardiovascular events in high-risk patients - Results of the Osaka follow-up study for carotid atherosclerosis 2 (OSACA2 study)
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DOI：
10.1159/000103114
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发表时间：
2007-01-01
影响因子：
2.9
通讯作者：
Hori, Masatsugu
中科院分区：
文献类型：
--
作者：
Kitagawa, Kazuo;Hougaku, Hidetaka;Hori, Masatsugu
背景和目的：有流行病学证据表明，颈动脉内膜中层厚度（IMT）增加是心血管疾病（CVD）事件的预测因子。然而，颈动脉IMT在高危患者中的临床管理危险因素的意义还没有得到充分的研究。本研究的目的是确定颈动脉IMT测量在这类患者中的有用性。方法：本研究包括900例有心血管危险因素或确诊动脉粥样硬化的门诊患者。颈动脉IMT计算为颈总动脉、分叉和颈内动脉的平均双侧IMT。基线血管危险因素、药物和CVD病史在入组时记录。前瞻性确定CVD事件的发生率。结果：在平均2.6年的随访期间，有64例CVD事件。CVD事件的相对风险（RR）随IMT增加而增加。在校正危险因素和CVD病史后，CVD事件与颈动脉IMT之间的相关性显著，显示从中三分位数（RR，2.5; 95%置信区间[CI]：1.0-6.3）到最高（RR，3.6; 95% CI：1.4-9.0），每个IMT三分位数的风险增加。当排除有CVD病史的患者（n = 574）时，即使在调整风险因素后，IMT的预测值也具有显著性（IMT每增加1 SD的风险比为1.57 [95% CI：1.11-2.20]）。结论：颈动脉IMT是高危患者血管事件的独立预测因子，这些患者的危险因素已得到临床控制。版权所有（c）2007 S. Karger AG，巴塞尔。
Background and Purpose: There is epidemiological evidence that increased carotid intima-media thickness (IMT) is a predictor of cardiovascular disease (CVD) events. However, the significance of carotid IMT in high-risk patients in whom risk factors are managed clinically has not been adequately investigated. The purpose of this study was to determine the usefulness of carotid IMT measurement in such patients. Methods: The study comprised 900 outpatients with cardiovascular risk factors or established atherosclerosis. Carotid IMT was calculated as the mean bilateral IMT of the common carotid artery, bifurcation, and internal carotid artery. Base-line vascular risk factors, medications, and history of CVD were recorded at the time of enrollment. The incidence of CVD events was determined prospectively. Results: During a mean follow-up period of 2.6 years, there were 64 CVD events. The relative risk (RR) of a CVD event increased with increased IMT. Association between CVD events and carotid IMT was significant after adjustment for risk factors and history of CVD, showing an increased risk per IMT tertile from the middle tertile (RR, 2.5; 95% confidence interval [CI]: 1.0-6.3) to the highest (RR, 3.6; 95% CI: 1.4-9.0). When patients with a history of CVD were excluded (n = 574), the predictive value of IMT was significant even after adjustment for risk factors (hazard ratio per 1 SD IMT increase was 1.57 [95% CI: 1.11-2.20]). Conclusions: Carotid IMT is an independent predictor of vascular events in high-risk patients in whom risk factors are managed clinically. Copyright (c) 2007 S. Karger AG, Basel.