Azcui Aparicio Roberto Enrique, Carrington Melinda J, Ball Jocasta, Abhayaratna Walter, Stewart Simon, Haluska Brian, Marwick Thomas H
Baker Heart and Diabetes Institute, P.O. Box 6492, Melbourne, VIC, 3004, Australia.
Torrens University Australia, Adelaide, Australia.
Int J Cardiovasc Imaging. 2022 Apr;38(4):739-749. doi: 10.1007/s10554-021-02459-x. Epub 2021 Nov 3.
The use of imaging to detect subclinical atherosclerosis helps to inform decision-making in people classified as having intermediate risk for cardiovascular disease (CVD). This study sought to use carotid plaque as an alternative to carotid intima media thickness (cIMT). Carotid ultrasound for assessment of cIMT and plaque was obtained in 1031 people (53 years, 61% female) with a family history of atherosclerotic CVD. The association of baseline characteristics and standard atherosclerotic risk factors (RFs) were sought with abnormal cIMT and plaque. The strongest association of plaque was a history of hypertension (odds ratio [OR] 1.87 (1.02-3.42), followed by age (OR 1.08 [95% CI 1.02-1.13]). For cIMT, the strongest association was smoking history (OR 1.57 [1.13-2.19]). The area under the receiver operator curve for the presence of plaque was 0.74 (95% CI 0.68-0.81, p < 0.001) and 0.65 (95% CI 0.61-0.70, p < 0.001) for cIMT elevation. Isolated elevation of cIMT (n = 178) was associated with increased total cholesterol, body mass index (BMI) and systolic blood pressure (SBP). Plaque only (n = 29) was associated with hypertension, male sex and older age. The presence of both markers abnormal (n = 22) was associated with a history of smoking. The absence of either abnormal cIMT or plaque (n = 773), was inversely associated with current or past smoking, SBP and BMI. Abnormalities in carotid vessels are present in a minority of intermediate risk patients with familial premature disease. The associations with RFs differ and are more closely associated with plaque.
利用成像技术检测亚临床动脉粥样硬化有助于为被归类为心血管疾病（CVD）中度风险人群的决策提供依据。本研究试图使用颈动脉斑块替代颈动脉内膜中层厚度（cIMT）。对1031名有动脉粥样硬化性CVD家族史的人（53岁，61%为女性）进行了颈动脉超声检查，以评估cIMT和斑块情况。研究了基线特征和标准动脉粥样硬化危险因素（RFs）与cIMT异常和斑块的关联。与斑块关联最强的是高血压病史（比值比[OR]1.87[1.02 - 3.42]），其次是年龄（OR 1.08[95%置信区间1.02 - 1.13]）。对于cIMT，关联最强的是吸烟史（OR 1.57[1.13 - 2.19]）。斑块存在时的受试者工作特征曲线下面积为0.74（95%置信区间0.68 - 0.81，p < 0.001），cIMT升高时为0.65（95%置信区间0.61 - 0.70，p < 0.001）。单纯cIMT升高（n = 178）与总胆固醇、体重指数（BMI）和收缩压（SBP）升高有关。仅斑块（n = 29）与高血压、男性和年龄较大有关。两种标志物均异常（n = 22）与吸烟史有关。cIMT或斑块均无异常（n = 773）与当前或既往吸烟、SBP和BMI呈负相关。在少数有家族性早发疾病的中度风险患者中存在颈动脉血管异常。与RFs的关联不同，且与斑块的关联更密切。
