Zhang Yanlei, Fang Xianghua, Hua Yang, Tang Zhe, Guan Shaochen, Wu Xiaoguang, Liu Hongjun, Liu Beibei, Wang Chunxiu, Zhang Zhongying, Gu Xiang, Hou Chengbei, Liu Chunxiao
1 Evidence-based Medical Center, Xuanwu Hospital, Capital Medical University, Beijing, China.
2 Department of vascular ultrasonography, Xuanwu Hospital, Capital Medical University, Beijing, China.
Angiology. 2018 Feb;69(2):120-129. doi: 10.1177/0003319717716842. Epub 2017 Jul 4.
We assessed the effect of asymptomatic carotid atherosclerosis (CAS) on the development of cardiovascular diseases (CVDs) in a community-based population aged ≥55 years in China. A total of 1376 residents underwent CAS assessment by ultrasonography in July 2009. New CVD events, including stroke and coronary heart events, were collected at the follow-up survey at the end of 2014. After adjusting for baseline demographic characteristics and traditional CVD risk factors, the risk of CVD in patients with minimal CAS (mean common carotid artery intima-media thickness [CCA-IMT] ≥1 mm and no plaques), nonstenotic plaques (carotid stenosis <50%), and stenotic plaques (carotid stenosis ≥50%) was 0.8 (hazard ratio [HR]: 0.75, 95% confidence interval [CI]: 0.33-1.69), 2.0 (HR: 2.01, 95% CI: 1.24-3.25), and 3.1 (HR: 3.05, 95% CI: 1.62-5.74) times greater, respectively, than that of patients without CAS (CCA-IMT <1 mm and no plaques). Our findings provide direct evidence of the independent predictive value of the severity of asymptomatic CAS for the development of CVD in older Chinese adults.
我们评估了无症状性颈动脉粥样硬化（CAS）对中国≥55岁社区人群心血管疾病（CVD）发生发展的影响。2009年7月，共有1376名居民接受了超声检查以评估CAS情况。在2014年末的随访调查中收集了包括中风和冠心病事件在内的新发CVD事件。在对基线人口统计学特征和传统CVD危险因素进行校正后，轻度CAS（平均颈总动脉内膜中层厚度[CCA-IMT]≥1mm且无斑块）、非狭窄性斑块（颈动脉狭窄<50%）和狭窄性斑块（颈动脉狭窄≥50%）患者发生CVD的风险分别是无CAS（CCA-IMT<1mm且无斑块）患者的0.8倍（风险比[HR]：0.75，95%置信区间[CI]：0.33 - 1.69）、2.0倍（HR：2.01，95%CI：1.24 - 3.25）和3.1倍（HR：3.05，95%CI：1.62 - 5.74）。我们的研究结果为无症状性CAS严重程度对中国老年成年人CVD发生发展具有独立预测价值提供了直接证据。
