Zyriax Birgit-Christiane, Dransfeld Kira, Windler Eberhard
Midwifery Science-Health Care Research and Prevention, Preventive Medicine and Nutrition, German Center for Health Services Research in Dermatology (CVderm), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany.
Midwifery Science-Health Care Research and Prevention, Preventive Medicine and Nutrition, Institute for Health Care Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Martinistr. 52-Bldg. N26, D-20246, Hamburg, Germany.
Ultrasound J. 2021 Mar 11;13(1):17. doi: 10.1186/s13089-021-00218-6.
Assessment of cardiovascular risk by scores lacks sensitivity and leaves the majority of future cardiovascular patients unidentified particularly individuals at low cardiovascular risk. The present analysis investigates into the correlation of carotid intima-media thickness (CIMT) and cardiovascular risk factors and derived scores as to the potential of improved cardiovascular risk prediction by combining the two.
The Stress, Atherosclerosis and ECG Study (STRATEGY) is a cross-sectional study of selectively healthy 107 women and 106 men without diagnosed and treated cardiovascular risk factors evenly distributed between 30 and 70 years. CIMT was determined by evaluating B-mode ultrasonograms offline according to a standardized protocol. The unpaired t-test was used to compare normal-distributed continuous variables, the Chi-squared test for normal-distributed categorical variables and the Mann-Whitney U test for non-normal distributed continuous variables. The association between risk prediction scores and CIMT was calculated by the Spearman rank correlation coefficient. Pearson correlation coefficient was used for the correlation between cardiovascular risk factors and CIMT. A multiple linear regression analysis was executed for the association of cardiovascular risk factors and CIMT.
Age, systolic blood pressure, fasting glucose, total, LDL- and non-HDL-cholesterol and waist circumference were significantly associated with CIMT (each P ≤ 0.03). The Framingham Risk Score, the Prospective Cardiovascular Münster Study Score and the European Society of Cardiology Score correlated significantly but only moderately with CIMT. The Framingham Risk Score considering BMI correlated most strongly and predicted 27% of the CIMT variance in men and 20% in women.
In individuals without overt cardiovascular risk factors and thus at low cardiovascular risk, CIMT and cardiovascular risk factors correlated only partially suggesting that combining CIMT and conventional risk factors or common derived scores may improve risk prediction in individuals at low cardiovascular risk. The clinical benefit as to cardiovascular events of such combined risk prediction needs to be explored in large prospective cohorts of still healthy low-risk volunteers. DRKS ID DRKS00015209 07/02/2019 retrospectively registered https://www.drks.de/drks_web/navigate.do?navigationId=resultsExt.
通过评分评估心血管风险缺乏敏感性，导致大多数未来的心血管疾病患者未被识别，尤其是心血管风险较低的个体。本分析研究颈动脉内膜中层厚度（CIMT）与心血管危险因素及衍生评分之间的相关性，以探讨将两者结合改善心血管风险预测的潜力。
应激、动脉粥样硬化与心电图研究（STRATEGY）是一项横断面研究，选取107名女性和106名男性，这些人选择性健康，无已诊断和治疗的心血管危险因素，年龄均匀分布在30至70岁之间。根据标准化方案离线评估B型超声心动图来确定CIMT。采用不成对t检验比较正态分布的连续变量，卡方检验用于正态分布的分类变量，曼-惠特尼U检验用于非正态分布的连续变量。风险预测评分与CIMT之间的关联通过斯皮尔曼等级相关系数计算。皮尔逊相关系数用于心血管危险因素与CIMT之间的相关性分析。对心血管危险因素与CIMT的关联进行多元线性回归分析。
年龄、收缩压、空腹血糖、总胆固醇、低密度脂蛋白胆固醇、非高密度脂蛋白胆固醇和腰围与CIMT显著相关（各P≤0.03）。弗雷明汉风险评分、明斯特前瞻性心血管研究评分和欧洲心脏病学会评分与CIMT显著相关，但相关性仅为中等程度。考虑体重指数的弗雷明汉风险评分相关性最强，可预测男性CIMT变异的27%，女性的20%。
在无明显心血管危险因素且心血管风险较低的个体中，CIMT与心血管危险因素仅部分相关，这表明将CIMT与传统危险因素或常用衍生评分相结合可能改善心血管风险较低个体的风险预测。这种联合风险预测对心血管事件的临床益处需要在大量仍健康的低风险志愿者前瞻性队列中进行探索。DRKS编号DRKS00015209 2019年2月7日回顾性注册https://www.drks.de/drks_web/navigate.do?navigationId=resultsExt
