Tschiderer Lena, Klingenschmid Gerhard, Seekircher Lisa, Willeit Peter
Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.
Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
Eur J Clin Invest. 2020 Apr;50(4):e13217. doi: 10.1111/eci.13217. Epub 2020 Mar 17.
Carotid intima-media thickness and carotid plaque are well-established imaging markers used to capture different stages of the atherosclerotic disease process. We aimed to quantify to which extent carotid intima-media thickness predicts incidence of first-ever carotid plaque.
Two independent reviewers conducted a comprehensive literature search of PubMed and Web of Science. To be eligible for inclusion, prospective studies were required to involve participants free of carotid plaque at baseline and report on the association of baseline carotid intima-media thickness with development of first-ever carotid plaque. Study-specific relative risks and 95% confidence intervals were collected and pooled using random-effects meta-analysis.
We identified seven relevant prospective studies involving a total of 9341 participants. Individuals were recruited between 1987 and 2012, average age at baseline was 54 years, and 63% were female. Studies reported on 1288 incident first-ever carotid plaques, occurring over an average maximum follow-up of 8.7 years. When individuals in the top fourth of baseline carotid intima-media thickness distribution were compared with those in the bottom fourth, the pooled relative risk for incidence of first-ever carotid plaque was 1.78 (95% confidence interval: 1.53-2.07, P < .001, I = 2.8%). The strength of association was not modified by mean baseline age, proportion of female participants, length of follow-up, year of baseline, and geographical location of the studies.
In general population studies, elevated baseline carotid intima-media thickness is associated with incidence of carotid plaque in individuals free of carotid plaque at baseline.
颈动脉内膜中层厚度和颈动脉斑块是公认的影像学标志物，用于反映动脉粥样硬化疾病进程的不同阶段。我们旨在量化颈动脉内膜中层厚度预测首次出现颈动脉斑块的发生率的程度。
两名独立审阅者对PubMed和Web of Science进行了全面的文献检索。为符合纳入标准，前瞻性研究要求参与者在基线时无颈动脉斑块，并报告基线颈动脉内膜中层厚度与首次出现颈动脉斑块的发生之间的关联。收集各研究的特定相对风险和95%置信区间，并使用随机效应荟萃分析进行汇总。
我们确定了7项相关的前瞻性研究，共涉及9341名参与者。个体招募时间为1987年至2012年，基线平均年龄为54岁，63%为女性。研究报告了1288例首次出现的颈动脉斑块事件，平均最长随访时间为8.7年。将基线颈动脉内膜中层厚度分布处于前四分之一的个体与处于后四分之一的个体进行比较时，首次出现颈动脉斑块的合并相对风险为1.78（95%置信区间：1.53 - 2.07，P <.001，I² = 2.8%）。关联强度不受平均基线年龄、女性参与者比例、随访时间、基线年份和研究地理位置的影响。
在一般人群研究中，基线颈动脉内膜中层厚度升高与基线时无颈动脉斑块的个体发生颈动脉斑块有关。
