Is carotid intima-media thickness useful in cardiovascular disease risk assessment? The Rotterdam study
Is carotid intima-media thickness useful in cardiovascular disease risk assessment? The Rotterdam study
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DOI：
10.1161/01.str.32.7.1532
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发表时间：
2001-07-01
期刊：
影响因子：
8.3
通讯作者：
Bots, ML
中科院分区：
文献类型：
--
作者：
del Sol, AI;Moons, KGM;Bots, ML
背景和目的：我们确定了颈总动脉内膜中层厚度（TMT）在预测未来冠心病和脑血管疾病中的贡献，当加入到已建立的风险factors.Methods中时，我们使用了来自巢式病例对照研究的数据，该研究包括374例中风或心肌梗死患者和1496例对照。所有受试者的年龄均为55岁及以上，并参加了鹿特丹研究。平均随访4.2年。（范围：0.1至6.5年）。我们评估了冠心病和脑血管疾病的哪些相关性有助于预测新发心肌梗死或卒中。采用Logistic回归模型和受试者工作特征曲线下面积（ROC面积）来量化已建立的危险因素的预测值和IMT的增加值。结果仅以年龄和性别建立的模型的ROC面积为0.65（95% CI为0.62 ~ 0.69），独立危险因素为既往心肌梗死和脑卒中。糖尿病、吸烟、收缩压、舒张压、总胆固醇和高密度脂蛋白胆固醇水平：这些危险因素使ROC面积从0.65增加到0.72（95%CI，0.69到0.75）。该模型正确预测了17%的冠心病和脑血管病受试者。当将颈总动脉IMT添加到先前的模型中时，ROC面积增加到0.75（95%CI，0.72至0.78）。当仅使用IMT测量时，ROC面积为0.71（95%CI，0.68至0.74），所有受试者中有14%被正确预测。有没有不同的测量sites were used.Conclusions-adding IMT的冠心病和脑血管疾病的风险函数时，作为一种筛选工具，在预测值的大幅增加，结果在ROC面积没有差异。
Background and Purpose-We determined the contribution of common carotid intima-media thickness (TMT) in the prediction of future coronary heart disease and cerebrovascular disease when added to established risk factors.Methods We used data from a nested case-control study comprising 374 subjects with either an incident stroke or a myocardial infarction and 1496 controls. All subjects were aged 55 years and older-and participated in the Rotterdam Study. Mean follow-up was 4.2 years.(range, 0.1 to 6.5 years). We evaluated which correlates of coronary heart disease and cerebrovascular: disease contribute to the prediction of either a new incident myocardial infarction or a stroke. Logistic regression modeling and the area under the receiver operating characteristic curve (ROC area) were used to quantify the predictive value of the established risk factors and the added value of IMT,Results-The ROC area of a model with age and sex only was 0.65 (95% CI, 0.62 to 0.69), Independent risk factors were previous myocardial infarction and stroke. diabetes mellitus, smoking, systolic blood pressure, diastolic blood pressure, and total and HDL cholesterol levels,:These risk factors increased the ROC area from 0.65 to 0.72 (95% CI, 0.69 to 0.75). This model correctly predicted 17% of all subjects with coronary heart disease and cerebrovascular disease. When common carotid IMT was added to the previous model, the ROC area increased to 0.75 (95% CI, 0.72 to 0.78). When only the IMT measurement was used, the ROC area was 0.71 (95% CI, 0.68 to 0.74), and 14% of all Subjects were correctly predicted. There was no difference in ROC area when different measurement sites were used.Conclusions-Adding IMT to a risk function for coronary heart disease and cerebrovascular disease does not result in a substantial increase in the predictive value when used as a screening tool.