Carotid intima-media thickening indicates a higher vascular risk across a wide age range - Prospective data from the Carotid Atherosclerosis Progression Study (CAPS)
Carotid intima-media thickening indicates a higher vascular risk across a wide age range - Prospective data from the Carotid Atherosclerosis Progression Study (CAPS)
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DOI：
10.1161/01.str.0000196964.24024.ea
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发表时间：
2006-01-01
期刊：
影响因子：
8.3
通讯作者：
Sitzer, M
中科院分区：
文献类型：
--
作者：
Lorenz, MW;von Kegler, S;Sitzer, M
背景与目的-颈动脉内膜-中膜厚度（IMT）是bb0 ~ 45岁年龄组血管事件的独立预测因子。然而，关于IMT在年轻人中的预测价值的信息很少。方法：在颈动脉粥样硬化进展研究（CAPS; n = 5056；年龄范围19 - 90岁；平均年龄50.1岁）中，在基线时评估颈总动脉（CCA） IMT、分岔IMT、颈内动脉IMT和血管危险因素。前瞻性地确定卒中、心肌梗死（MI）和死亡的发生率。使用Cox比例风险回归模型分别分析年轻（< 50岁，n = 2436）和老年（>= 50岁，n = 2620）受试者的数据。结果-在平均4.2年的随访期间，有228例心肌梗死，107例中风，50例死亡。所有颈动脉段的IMT对所有终点都具有高度预测性（例如，每1 SD CCA-IMT增加的危险率比[HRRs]为心肌梗死的1.43 [95% CI: 1.35至1.51]，卒中的1.47[1.35至1.60]，心肌梗死、卒中或死亡的1.45[1.38至1.52]，均P < 0.0001）。即使在调整了年龄、性别和血管危险因素后，CCA-IMT和分岔IMT对心肌梗死和合并终点的预测价值仍然显著。对于后者，年轻人的HRR明显高于老年人（例如，每0.1 mm CCA-IMT的HRR为1.34[1.16至1.55]对1.10[1.05至1.15]；年龄- imt相互作用的P = 0.011）。结论：颈动脉IMT可以独立预测未来的血管事件。它对年轻受试者的预测价值至少与老年受试者一样高。
Background and Purpose - Carotid intima-media thickness (IMT) is an independent predictor of vascular events in age groups >45 years. However, there is little information about the predictive value of IMT in younger individuals.Methods - In the Carotid Atherosclerosis Progression Study (CAPS; n = 5056; age range 19 to 90 years; mean age 50.1 years), common carotid artery (CCA) IMT, bifurcation IMT, internal carotid artery IMT and vascular risk factors were evaluated at baseline. The incidence of stroke, myocardial infarction (MI), and death was determined prospectively. Data for younger (< 50 years; n = 2436) and older subjects (>= 50 years; n = 2620) were analyzed separately using Cox proportional hazard regression models.Results - During a mean follow-up period of 4.2 years, there were 228 cases of MI, 107 strokes, and 50 deaths. IMT at all carotid segments was highly predictive of all end points (eg, hazard rate ratios [HRRs] per 1 SD CCA-IMT increase were 1.43 [95% CI: 1.35 to 1.51] for MI, 1.47 [ 1.35 to 1.60] for stroke, and 1.45 [1.38 to 1.52] for MI, stroke or death; all P < 0.0001). Even after adjustment for age, sex, and vascular risk factors, the predictive value of CCA-IMT and bifurcation IMT remained significant for MI and the combined end point. For the latter, the HRRs were considerably higher in the younger than in the older age group (eg, HRR per 0.1 mm CCA-IMT was 1.34 [1.16 to 1.55] vis-a-vis 1.10 [1.05 to 1.15]; P = 0.011 for age-IMT interaction).Conclusions - Carotid IMT independently predicts future vascular events. Its predictive value is at least as high in younger subjects as in older subjects.