Department of Neurology, Soonchunhyang University School of Medicine, Seoul, Republic of Korea.
Atherosclerosis. 2012 Jul;223(1):160-5. doi: 10.1016/j.atherosclerosis.2012.05.012. Epub 2012 May 16.
Carotid stenosis and plaque stability are critical determinants of risk for ischemic stroke. The aim of this study is to elucidate the association of CAC with carotid stenosis and plaque characteristics.
We examined data from the Multi-Ethnic Study of Atherosclerosis (MESA), a prospective cohort study of subclinical cardiovascular disease in multiethnic participants (N = 6814). The association between CAC measured by computed tomography and carotid ultrasonography of carotid plaque was examined using multiple logistic linear models adjusting for traditional vascular risk factors including ethnicity. We also developed ethnic specific models to compare the relationship between CAC and carotid disease across the four ethnicities.
Significant carotid stenosis was associated with the presence of CAC (OR 1.73; 95% CI, 1.20-2.49) and log-transformed Agatston score (OR per 1 point increase, 1.18; 95% CI 1.04-1.35). Overt carotid stenosis was also associated with the presence of CAC (OR, 2.34; 95% CI, 1.93-2.83) and log-transformed Agatston score (OR per 1 point increase, 1.53; 95% CI 1.38-1.69). Irregular plaque surface was associated with the presence of CAC (OR, 1.87; 95% CI 1.50-2.32) and the log-transformed Agatston score (OR per 1 point 1 increase, 1.31; 95% CI 1.16-1.48). Associations between CAC and stenosis/stability were not different across ethnicities.
Both the presence of CAC and log-transferred Agatston score are independently associated with significant/overt carotid stenosis and carotid plaque surface irregularity regardless of ethnicity. The subjects with a positive or increased CAC score are more likely to have carotid disease potentially increasing their risk for future ischemic stroke.
颈动脉狭窄和斑块稳定性是缺血性卒中风险的关键决定因素。本研究旨在阐明 CAC 与颈动脉狭窄和斑块特征的关系。
我们检查了多民族动脉粥样硬化研究(MESA)的数据,这是一项针对多种族参与者亚临床心血管疾病的前瞻性队列研究(N=6814)。使用多元逻辑线性模型,在调整包括种族在内的传统血管危险因素后,检查了由计算机断层扫描测量的 CAC 与颈动脉超声检查的颈动脉斑块之间的关联。我们还开发了特定于种族的模型,以比较四种族之间 CAC 与颈动脉疾病之间的关系。
显著的颈动脉狭窄与 CAC 的存在相关(OR 1.73;95%CI,1.20-2.49)和对数转换的 Agatston 评分(OR 每增加 1 点,1.18;95%CI 1.04-1.35)。明显的颈动脉狭窄也与 CAC 的存在相关(OR,2.34;95%CI,1.93-2.83)和对数转换的 Agatston 评分(OR 每增加 1 点,1.53;95%CI 1.38-1.69)。不规则的斑块表面与 CAC 的存在相关(OR,1.87;95%CI,1.50-2.32)和对数转换的 Agatston 评分(OR 每增加 1 点,1.31;95%CI 1.16-1.48)。CAC 与狭窄/稳定性之间的关联在不同种族之间没有差异。
无论种族如何,CAC 的存在和对数转换的 Agatston 评分均与显著/明显的颈动脉狭窄和颈动脉斑块表面不规则性独立相关。CAC 评分阳性或增加的患者更有可能患有颈动脉疾病,这可能会增加他们未来发生缺血性卒中的风险。