Acoustic shadowing on B-mode ultrasound of the carotid artery predicts ischemic stroke - The atherosclerosis risk in communities (ARIC) study
Acoustic shadowing on B-mode ultrasound of the carotid artery predicts ischemic stroke - The atherosclerosis risk in communities (ARIC) study
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DOI：
10.1161/01.str.32.5.1120
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发表时间：
2001-05-01
期刊：
影响因子：
8.3
通讯作者：
Heiss, G
中科院分区：
文献类型：
--
作者：
Hunt, KJ;Evans, GW;Heiss, G
背景和目的-我们研究了颈动脉病变（CAL）的关系，有和没有声影（AS），缺血性中风事件的动脉粥样硬化风险在Communities study coherent. Methods的研究人群包括13 123名男性和女性，年龄在45至64岁，和免费的中风，在1986-1989年期间检查。在平均8.0年的随访时间内，226例缺血性卒中（血栓栓塞性脑梗死）被确定并按标准化方案分类。三个水平的暴露定义的基础上存在的B型超声检测CAL和AS在3厘米段的颈动脉为中心的bifurcation.Results-The风险比缺血性中风调整毛皮年龄，种族，和研究地点的妇女与CAL没有AS，与那些没有GAL，是1.92（95% CI，1.23，3.01），并且将CAL合并AS的患者与未CAL的患者进行比较的风险比为4.01（95% CI，2.28，7.06）。男性的相应风险比为1.99（95% CI，1.36，2.91）和2.23（95% CI，1.32，3.79）。尽管调整了糖尿病、高血压药物、收缩压、左心室肥厚评分、纤维蛋白原、血管性血友病因子抗原和吸烟状况，这些相关性有所减弱，但与无CAL证据相比，AS伴CAL仍然是女性缺血性卒中的统计学显著预测因子，结论：B超检测的CALs和AS可作为动脉粥样硬化的标志物，从而可预测缺血性卒中。
Background and Purpose-We examined the relationship of carotid artery lesions (CALs), with and without acoustic shadowing (AS), to incident ischemic stroke events in the Atherosclerosis Risk in Communities study cohort.Methods-The study population consisted of 13 123 men and women aged 45 to 64 years, and free of stroke, examined during 1986-1989. Over an average follow-up time of 8.0 years, 226 incident ischemic stroke cases (thromboembolic brain infarctions) were identified and classified by a standardized protocol. Three levels of exposure were defined on the basis of the presence of B-mode ultrasound-detected CALs and AS in a 3-cm Segment of the carotid arteries centered at the bifurcation.Results-The hazard ratio for ischemic stroke adjusted fur age, ethnicity, and study site for women with a CAL without AS, compared with those without a GAL, was 1.92 (95% CI, 1.23, 3.01), and the hazard ratio comparing those with a CAL with AS with those without a CAL was 4.01 (95% CI, 2.28, 7.06). The corresponding hazard ratios fur men were 1.99 (95% CI, 1.36, 2.91) and 2.23 (95% CI, 1.32, 3.79). Although adjustment for diabetes, hypertension medication, systolic blood pressure, left ventricular hypertrophy score, fibrinogen, von Willebrand factor antigen, and smoking status attenuated these associations somewhat, when compared with no evidence of CALs, CALs with AS remained statistically significant predictors of ischemic stroke in women, while CALs without AS were predictive of ischemic stroke in men.Conclusions-B-mode ultrasound-detected CALs and AS serve as markers of atherosclerosis and thus are predictive of ischemic stroke.