Carotid intima-media thickness and the risk of new vascular events in patients with manifest atherosclerotic disease: the SMART study
Carotid intima-media thickness and the risk of new vascular events in patients with manifest atherosclerotic disease: the SMART study
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DOI：
10.1093/eurheartj/ehl136
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发表时间：
2006-08-01
影响因子：
39.3
通讯作者：
Algra, Ale
中科院分区：
文献类型：
--
作者：
Dijk, Joke M.;van der Graaf, Yolanda;Algra, Ale
颈动脉内膜中层厚度（CIMT）是普通人群血管事件的独立预测因子。目前，很少有人知道CIMT和新的血管事件之间的关系，在患者的显着动脉疾病。我们的目的是评估这种关系的强度。方法和结果这项研究是在第一个连续2374例明显动脉疾病的患者参加了队列研究SMART（第二表现动脉疾病），一个队列研究中的患者明显动脉疾病或心血管危险因素。在基线时测量双侧颈动脉的共同CIMT。血管事件包括血管性死亡、非致死性心肌梗死或卒中，以先发生者为准，经年龄和性别校正后，常见CIMT增加1 SD（类似于0.32 mm）与血管事件的发生相关[风险比（HR）1.18; 95%置信区间（95%CI）1.04-1.32]。CIMT增加与缺血性卒中发生率最密切相关（HR 1.35; 95% CI 1.16-1.59）。在2177例无大颈总动脉斑块（所有测量部位CIMT < 2 mm）的患者中，结果相似。结果是相似的额外调整后的危险因素的CIMT和vascular risk.Conclusion常见CIMT与新的血管事件的发生，主要是缺血性卒中，在明显的动脉疾病的患者。这种关系似乎并不依赖于斑块的存在。
Aims Carotid intima-media thickness (CIMT) is an independent predictor of vascular events in the general population. Currently, little is known about the relationship between CIMT and new vascular events in patients with manifest arterial disease. We aimed to assess the strength of this relationship.Methods and results The study was performed in the first consecutive 2374 patients with manifest arterial disease enrolled in the cohort study SMART (Second Manifestations of ARTerial disease), a cohort study among patients with manifest arterial disease or cardiovascular risk factors. Common CIMT was measured at baseline in both carotid arteries. Vascular events were vascular death, non-fatal myocardial infarction, or stroke, whichever occurred first.Adjusted for age and sex, an increase in common CIMT of 1 SD (similar to 0.32 mm) was associated with the occurrence of vascular events [hazard ratio (HR) 1.18; 95% confidence interval (95% CI) 1.04-1.32]. Increasing CIMT was most strongly related to ischaemic stroke incidence (HR 1.35; 95% CI 1.16-1.59). Results were similar in the 2177 patients without large common carotid plaques (CIMT < 2 mm at all measurements sites). The findings were similar after additional adjustment for risk factors of CIMT and vascular risk.Conclusion Common CIMT is associated with the occurrence of new vascular events, mostly for ischaemic stroke, in patients with manifest arterial disease. This relation does not appear to depend on the presence of plaques.