Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, CA, USA.
Atherosclerosis. 2010 Jul;211(1):266-70. doi: 10.1016/j.atherosclerosis.2010.01.013. Epub 2010 Jan 21.
Recent studies indicate that subclavian stenosis (SS), diagnosed by a large systolic blood pressure difference (SBPD) between the right and left brachial arteries, is associated with cardiovascular disease (CVD) risk factors and outcomes. We sought to describe the epidemiology of SS and determine its association with markers of subclinical CVD in the baseline cohort of the Multi-Ethnic Study of Atherosclerosis.
We defined SS by an absolute SBPD>or=15 mmHg. Peripheral artery disease (PAD) was defined by an ankle-brachial index<or=0.90. The coronary artery calcium score (CAC) and the common carotid artery intima-media thickness (CCA-IMT) were measured by computed tomography and B-mode ultrasound, respectively. Odds ratios for the associations of SS with risk factors and subclinical disease were estimated using logistic regression.
Of 6743 subjects studied, 307 participants (4.6%) had SS, with a higher prevalence in women (5.1%) than men (3.9%), and in African Americans (7.4%) and non-Hispanic whites (5.1%) than Hispanic (1.9%) or Chinese (1.0%) participants (p<0.01). In a model including age, gender, ethnicity, traditional and novel CVD risk factors, significant associations with SS were observed for C-reactive protein (highest vs. three lower quartiles: OR=1.41; 95%CI: 1.06-1.87) and brachial artery pulse pressure (OR=1.12/10 mmHg; 95%CI: 1.03-1.21). Adjusted for age, gender, ethnicity, traditional and novel CVD risk factors, SS was significantly associated with PAD (OR=2.35; 1.55-3.56), with CCA-IMT (highest vs. the lower three quartiles: OR=1.32; 1.00-1.75), and high CAC (score>100 vs. score=0; OR=1.43; 1.03-2.01).
The subclavian stenosis is positively associated with other markers of subclinical atherosclerosis.
最近的研究表明，锁骨下狭窄（SS）通过右侧和左侧肱动脉之间的较大收缩期血压差异（SBPD）来诊断，与心血管疾病（CVD）危险因素和结局相关。我们试图描述 SS 的流行病学，并确定其在动脉粥样硬化多民族研究的基线队列中与亚临床 CVD 标志物的关系。
我们通过绝对 SBPD>或=15mmHg 来定义 SS。外周动脉疾病（PAD）定义为踝臂指数<或=0.90。通过计算机断层扫描和 B 型超声分别测量冠状动脉钙评分（CAC）和颈总动脉内膜中层厚度（CCA-IMT）。使用逻辑回归估计 SS 与危险因素和亚临床疾病之间关联的优势比。
在 6743 名研究对象中，307 名参与者（4.6%）患有 SS，女性（5.1%）高于男性（3.9%），非裔美国人（7.4%）和非西班牙裔白人（5.1%）高于西班牙裔（1.9%）或中国人（1.0%）参与者（p<0.01）。在包括年龄、性别、种族、传统和新型 CVD 危险因素的模型中，观察到 SS 与 C-反应蛋白（最高与三个较低四分位数相比：OR=1.41；95%CI：1.06-1.87）和肱动脉脉压（OR=1.12/10mmHg；95%CI：1.03-1.21）显著相关。在调整年龄、性别、种族、传统和新型 CVD 危险因素后，SS 与 PAD（OR=2.35；1.55-3.56）、CCA-IMT（最高与三个较低四分位数相比：OR=1.32；1.00-1.75）和高 CAC（评分>100 与评分=0 相比：OR=1.43；1.03-2.01）显著相关。
锁骨下狭窄与其他亚临床动脉粥样硬化标志物呈正相关。
