Iwai-Takano Masumi, Watanabe Tomoyuki, Ohira Tetsuya
Department of Epidemiology, Fukushima Medical University, Fukushima, Japan.
Fukushima Prefectural General Hygiene Institute, Fukushima, Japan.
Echocardiography. 2019 Dec;36(12):2227-2233. doi: 10.1111/echo.14536. Epub 2019 Nov 23.
Kinking of the internal carotid artery is a cardiovascular (CV) risk factor. However, it remains unclear as to whether kinking of the common carotid artery (CCA) can also predict CV events. We conducted a long-term follow-up study to examine whether CCA kinking as assessed by carotid ultrasonography is a predictor of CV events in asymptomatic patients with CV risk factors.
We enrolled 598 patients (mean age, 66.8 ± 11.8 years) who were divided into two groups according to CCA kinking severity: kinking of 0-29° (Group I); and kinking at ≥30° (Group II). We assessed whether CCA kinking predicts CV events during follow-up.
A total of 91 CV events were observed during the follow-up period (median, 124 months). Hypertension (P < .0001), prior CV events (P < .0001), CCA kinking (P < .0001), intima-media thickness (P < .0001), and max plaque score (P < .0001) were significantly higher in patients with CV events than those without. The age-adjusted hazard ratio of CCA kinking for CV events was 3.42 (95% CI: 2.2-5.3) in Group II compared to Group I. Cox proportional hazard regression analysis revealed that CCA kinking (HR: 3.02, 95% CI: 1.97-4.67), prior CV events (HR: 2.53 95% CI: 1.604.00), hypertension (HR: 2.19 95% CI: 1.17-4.57), and age (HR: 1.04, 95% CI: 1.02-1.07) were independent predictors of CV events.
CCA kinking is a powerful independent predictor of CV events in asymptomatic patients with CV risk factors.
颈内动脉扭曲是一种心血管（CV）危险因素。然而，颈总动脉（CCA）扭曲是否也能预测心血管事件仍不清楚。我们进行了一项长期随访研究，以检验经颈动脉超声评估的CCA扭曲是否为有心血管危险因素的无症状患者发生心血管事件的预测指标。
我们纳入了598例患者（平均年龄66.8±11.8岁），根据CCA扭曲严重程度将其分为两组：0-29°扭曲（第一组）；≥30°扭曲（第二组）。我们评估了CCA扭曲是否能预测随访期间的心血管事件。
随访期间共观察到91例心血管事件（中位数为124个月）。发生心血管事件的患者的高血压（P<.0001）、既往心血管事件（P<.0001）、CCA扭曲（P<.0001）、内膜中层厚度（P<.0001）和最大斑块评分（P<.0001）显著高于未发生心血管事件的患者。与第一组相比，第二组中CCA扭曲导致心血管事件的年龄调整后风险比为3.42（95%CI：2.2-5.3）。Cox比例风险回归分析显示，CCA扭曲（HR：3.02，95%CI：1.97-4.67）、既往心血管事件（HR：2.53，95%CI：1.60-4.00）、高血压（HR：2.19，95%CI：1.17-4.57）和年龄（HR：1.04，95%CI：1.02-1.07）是心血管事件的独立预测因素。
CCA扭曲是有心血管危险因素的无症状患者发生心血管事件的有力独立预测指标。
