Does subclinical atherosclerosis burden identify the increased risk of cardiovascular disease mortality among United Kingdom Indian Asians? A population study
Does subclinical atherosclerosis burden identify the increased risk of cardiovascular disease mortality among United Kingdom Indian Asians? A population study
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DOI：
10.1016/j.ahj.2011.06.018
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发表时间：
2011-09-01
影响因子：
4.8
通讯作者：
Senior, Roxy
中科院分区：
文献类型：
--
作者：
Chahal, Navtej S.;Lim, Tiong K.;Senior, Roxy
背景生活在英国的印度亚洲人与欧洲本土白人相比，心血管疾病（CVD）死亡风险高出50%以上。其过度死亡的机制尚不清楚，也没有有效的工具能够识别这种增加的风险。在颈动脉中检测到的亚临床动脉粥样硬化负担是主要CVD事件的既定指标。我们假设印度亚洲人中心血管疾病患病率的增加反映在与欧洲白人相比，他们有更大的亚临床颈动脉粥样硬化负担。方法我们研究了2,288名健康受试者和148名来自伦敦生命科学前瞻性人群研究的已知心血管疾病患者，这些患者接受颈动脉超声检查评估内膜中层厚度（IMT）、斑块患病率、结果与欧洲白人相比，印度裔亚洲人CVD的患病率显著较高（优势比1.72，95% CI 1.2-2.3）。欧洲白人的内膜中层厚度略高于印度亚裔（0.66 vs 0.65 mm，P = 0.06），反映了他们较高的脆性风险评分。调整后的心血管危险因素，有没有显着差异，IMT，斑块患病率，或斑块回声两个种族之间的组，无论CVD status.Conclusion颈动脉粥样硬化的负担并没有确定英国印度亚洲人CVD的风险显着增加。其他标志物和疾病的机制需要在这个高风险群体中进行调查。(Am Heart J 2011;162：460-6.）
Background Indian Asians living in the United Kingdom have a >50% higher risk of cardiovascular disease (CVD) death compared with native European whites. The mechanisms underlying their excess mortality are not clear, and there are no validated tools capable of identifying this increased risk. The burden of subclinical atherosclerosis detected in the carotid arteries is an established prognosticator for major CVD events. We hypothesized that the increased prevalence of CVD among Indian Asians would be reflected by their having a greater burden of subclinical carotid artery atherosclerosis compared with European whites.Methods We studied 2,288 healthy subjects and 148 patients with known CVD from the London Life Sciences Prospective Population study who underwent carotid ultrasonography for assessment of intima-media thickness (IMT), plaque prevalence, and plaque echogenicity.Results The prevalence of CVD was significantly higher among Indian Asians compared with European whites (odds ratio 1.72, 95% CI 1.2-2.3). Intima-media thickness was slightly higher in European whites compared with that of Indian Asians (0.66 vs 0.65 mm, P = .06), reflecting their higher Framingham Risk Score. After adjustment for cardiovascular risk factors, there were no significant differences in IMT, plaque prevalence, or plaque echogenicity between the 2 ethnic groups regardless of CVD status.Conclusion The burden of carotid atherosclerosis does not identify the markedly increased risk of CVD among United Kingdom Indian Asians. Other markers and mechanisms of disease require investigation in this high-risk group. (Am Heart J 2011;162:460-6.)