Department of Radiology, # 299, Tufts Medical Center, 800 Washington Street, Boston, MA 02111, USA.
Stroke. 2011 Nov;42(11):3017-21. doi: 10.1161/STROKEAHA.111.625186. Epub 2011 Sep 1.
Carotid artery intima-media thickness (IMT) is a marker of cardiovascular disease associated with incident stroke. We studied whether IMT rate of change is associated with stroke.
We studied 5028 participants of the Multi-Ethnic Study of Atherosclerosis (MESA) comprising white, Chinese, Hispanic, and black participants free of cardiovascular disease. In this MESA IMT progression study, IMT rate of change (mm/year) was the difference in right common carotid artery far wall IMT (mm) divided by the interval between 2 ultrasound examinations (median interval, 32 months). Common carotid artery IMT was measured in a region free of plaque. Cardiovascular risk factors and baseline IMT were determined when IMT rate of change was measured. Multivariable Cox proportional hazards models generated hazard risk ratios (HR) with cardiovascular risk factors, ethnicity, and education level/income as predictors.
There were 42 first-time strokes seen during a mean follow-up of 3.22 years (median, 3.0 years). Average age was 64.2 years, with 48% males. In multivariable models, age (HR, 1.05 per year), systolic blood pressure (HR, 1.02 per mm Hg), lower high-density lipoprotein cholesterol levels (HR, 0.96 per mg/dL), and IMT rate of change (HR, 1.23 per 0.05 mm/year; 95% confidence limit, 1.02-1.48) were significantly associated with incident stroke. The upper quartile of IMT rate of change had HR of 2.18 (95% confidence limit, 1.07-4.46) compared to the lower 3 quartiles combined.
Common carotid artery IMT progression is associated with incident stroke in this cohort free of prevalent cardiovascular disease and atrial fibrillation at baseline.
颈动脉内膜中层厚度（IMT）是与中风事件相关的心血管疾病的标志物。我们研究了 IMT 变化率是否与中风有关。
我们研究了无心血管疾病的多民族动脉粥样硬化研究（MESA）中的 5028 名参与者，包括白种人、中国人、西班牙裔和黑人。在这项 MESA IMT 进展研究中，IMT 变化率（mm/年）是右颈总动脉远壁 IMT（mm）差值除以两次超声检查之间的间隔（中位数间隔，32 个月）。颈总动脉 IMT 是在无斑块的区域测量的。当测量 IMT 变化率时，确定了心血管危险因素和基线 IMT。多变量 Cox 比例风险模型生成了风险比（HR），心血管危险因素、种族和教育水平/收入作为预测因素。
在平均 3.22 年（中位数，3.0 年）的随访中，有 42 例首次中风。平均年龄为 64.2 岁，男性占 48%。在多变量模型中，年龄（HR，每年 1.05）、收缩压（HR，每毫米汞柱 1.02）、较低的高密度脂蛋白胆固醇水平（HR，每毫克/分升 0.96）和 IMT 变化率（HR，每 0.05mm/年增加 1.23；95%置信区间，1.02-1.48）与中风事件显著相关。与后 3 个四分位值相比，IMT 变化率的上四分位数的 HR 为 2.18（95%置信区间，1.07-4.46）。
在这个无基线心血管疾病和心房颤动的队列中，颈总动脉 IMT 进展与中风事件相关。
