Comprehensive Heart Failure Center Würzburg, University and University Hospital Würzburg, Straubmühlweg 15, 97080, Würzburg, Germany.
Department of Internal Medicine I, University Hospital Würzburg, Würzburg, Germany.
BMC Cardiovasc Disord. 2019 Apr 4;19(1):84. doi: 10.1186/s12872-019-1044-0.
The guideline recommendation to not measure carotid intima-media thickness (CIMT) for cardiovascular risk prediction is based on the assessment of just one single carotid segment. We evaluated whether there is a segment-specific association between different measurement locations of CIMT and cardiovascular risk factors.
Subjects from the population-based STAAB cohort study comprising subjects aged 30 to 79 years of the general population from Würzburg, Germany, were investigated. CIMT was measured on the far wall of both sides in three different predefined locations: common carotid artery (CCA), bulb, and internal carotid artery (ICA). Diabetes, dyslipidemia, hypertension, smoking, and obesity were considered as risk factors. In multivariable logistic regression analysis, odds ratios of risk factors per location were estimated for the endpoint of individual age- and sex-adjusted 75th percentile of CIMT.
2492 subjects were included in the analysis. Segment-specific CIMT was highest in the bulb, followed by CCA, and lowest in the ICA. Dyslipidemia, hypertension, and smoking were associated with CIMT, but not diabetes and obesity. We observed no relevant segment-specific association between the three different locations and risk factors, except for a possible interaction between smoking and ICA.
As no segment-specific association between cardiovascular risk factors and CIMT became evident, one simple measurement of one location may suffice to assess the cardiovascular risk of an individual.
不建议通过测量颈动脉内膜中层厚度(CIMT)来预测心血管风险,这一指南推荐主要基于对单一颈动脉节段的评估。我们评估了 CIMT 不同测量位置与心血管危险因素之间是否存在节段特异性关联。
研究对象来自基于人群的 STAAB 队列研究,包括德国维尔茨堡市 30 至 79 岁的普通人群。在三个预先定义的位置(颈总动脉(CCA)、颈动脉窦和颈内动脉(ICA))的远侧壁测量 CIMT。糖尿病、血脂异常、高血压、吸烟和肥胖被视为危险因素。在多变量逻辑回归分析中,根据 CIMT 年龄和性别调整后第 75 百分位数的个体终点,估计每个位置的危险因素的比值比。
共纳入 2492 名受试者。节段特异性 CIMT 在颈动脉窦最高,CCA 次之,ICA 最低。血脂异常、高血压和吸烟与 CIMT 相关,但糖尿病和肥胖与 CIMT 无关。除了吸烟和 ICA 之间可能存在的相互作用外,我们未观察到三个不同位置与危险因素之间存在明显的节段特异性关联。
由于未发现心血管危险因素与 CIMT 之间存在明显的节段特异性关联,因此,单次测量一个位置可能足以评估个体的心血管风险。