颈总动脉内膜中层厚度与45岁以下成年人的心血管事件相关。
Common carotid intima-media thickness relates to cardiovascular events in adults aged <45 years.
作者信息
Eikendal Anouk L M, Groenewegen Karlijn A, Anderson Todd J, Britton Annie R, Engström Gunnar, Evans Greg W, de Graaf Jacqueline, Grobbee Diederick E, Hedblad Bo, Holewijn Suzanne, Ikeda Ai, Kitagawa Kazuo, Kitamura Akihiko, Lonn Eva M, Lorenz Matthias W, Mathiesen Ellisiv B, Nijpels Giel, Dekker Jacqueline M, Okazaki Shuhei, O'Leary Daniel H, Polak Joseph F, Price Jacqueline F, Robertson Christine, Rembold Christopher M, Rosvall Maria, Rundek Tatjana, Salonen Jukka T, Sitzer Matthias, Stehouwer Coen D A, Hoefer Imo E, Peters Sanne A E, Bots Michiel L, den Ruijter Hester M
机构信息
From the Department of Radiology (A.L.M.E.), Department of Cardiovascular Epidemiology, Julius Center for Health Sciences and Primary Care (K.A.G., D.E.G., S.A.E.P., M.L.B., H.M.d.R.), and Department of Experimental Cardiology (I.E.H., H.M.d.R.), University Medical Center, Utrecht, Utrecht, The Netherlands; Department of Cardiac Sciences and Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada (T.J.A.); Department of Epidemiology and Public Health University College London, London, United Kingdom (A.R.B.); Department of Clinical Sciences in Malmö, Lund University, Skåne University Hospital, Malmö, Sweden (G.E., B.H., M.R.); Department of Biostatistical Sciences and Neurology, Wake Forest School of Medicine, Winston-Salem, NC (G.W.E.); Division of Vascular Medicine, Department of General Internal Medicine, Radboud University Medical Centre Nijmegen, Nijmegen, The Netherlands (J.d.G., S.H.); Department of Clinical Epidemiology, University of Malaya Medical Center, Kuala Lumpur, Malaysia (D.E.G.); Osaka Medical Center for Health Science and Promotion, Osaka, Japan (A.I., A.K.); Department of Neurology, Tokyo Women Medical University, Tokyo, Japan (K.K.); Division of Cardiology and Population Health Research Institute, Department of Medicine, McMaster University, Hamilton, Ontario, Canada (E.M.L.); Department of Neurology, University Hospital, Goethe-University, Frankfurt am Main, Germany (M.W.L., M.S.); Brain and Circulation Research Group, Department of Clinical Medicine, University of Tromsø, Tromsø, Norway (E.B.M.); Department of General Practice, EMGO Institute, VU Medical Center, Amsterdam, The Netherlands (G.N., J.M.D.); Stroke Center, Department of Neurology, Osaka University Graduate School of Medicine, Osaka, Japan (S.O.); Department of Radiology, Tufts Medical Center, Boston, MA (D.H.O'L., J.F.P.); Centre for Population Health Sciences, University of Edinburgh, Edinburgh, United Kingdom (J.F.P., C.R.); Cardiology Division, De
出版信息
Hypertension. 2015 Apr;65(4):707-13. doi: 10.1161/HYPERTENSIONAHA.114.04658. Epub 2015 Jan 26.
Although atherosclerosis starts in early life, evidence on risk factors and atherosclerosis in individuals aged <45 years is scarce. Therefore, we studied the relationship between risk factors, common carotid intima-media thickness (CIMT), and first-time cardiovascular events in adults aged <45 years. Our study population consisted of 3067 adults aged <45 years free from symptomatic cardiovascular disease at baseline, derived from 6 cohorts that are part of the USE-IMT initiative, an individual participant data meta-analysis of general-population-based cohort studies evaluating CIMT measurements. Information on risk factors, CIMT measurements, and follow-up of the combined end point (first-time myocardial infarction or stroke) was obtained. We assessed the relationship between risk factors and CIMT and the relationship between CIMT and first-time myocardial infarction or stroke using a multivariable linear mixed-effects model and a Cox proportional-hazards model, respectively. During a follow-up of 16.3 years, 55 first-time myocardial infarctions or strokes occurred. Median CIMT was 0.63 mm. Of the risk factors under study, age, sex, diastolic blood pressure, body mass index, total cholesterol, and high-density lipoprotein cholesterol related to CIMT. Furthermore, CIMT related to first-time myocardial infarction or stroke with a hazard ratio of 1.40 per SD increase in CIMT, independent of risk factors (95% confidence interval, 1.11-1.76). CIMT may be a valuable marker for cardiovascular risk in adults aged <45 years who are not yet eligible for standard cardiovascular risk screening. This is especially relevant in those with an increased, unfavorable risk factor burden.
尽管动脉粥样硬化始于早年，但关于45岁以下个体的危险因素与动脉粥样硬化的证据却很少。因此，我们研究了45岁以下成年人的危险因素、颈总动脉内膜中层厚度（CIMT）与首次心血管事件之间的关系。我们的研究人群包括3067名45岁以下的成年人，他们在基线时无有症状的心血管疾病，来自6个队列，这些队列是USE-IMT倡议的一部分，USE-IMT倡议是一项基于人群队列研究的个体参与者数据荟萃分析，评估CIMT测量值。获取了有关危险因素、CIMT测量值以及联合终点（首次心肌梗死或中风）随访的信息。我们分别使用多变量线性混合效应模型和Cox比例风险模型评估了危险因素与CIMT之间的关系以及CIMT与首次心肌梗死或中风之间的关系。在16.3年的随访期间，发生了55例首次心肌梗死或中风。CIMT中位数为0.63毫米。在所研究的危险因素中，年龄、性别、舒张压、体重指数、总胆固醇和高密度脂蛋白胆固醇与CIMT相关。此外，CIMT与首次心肌梗死或中风相关，CIMT每增加1个标准差，风险比为1.40，独立于危险因素（95%置信区间为1.11-1.76）。对于尚未符合标准心血管风险筛查条件的45岁以下成年人，CIMT可能是心血管风险的一个有价值的标志物。这在那些危险因素负担增加且不利的人群中尤其重要。
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