Center for Health Research, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
Department of Neurology, University Hospital Ostrava, Ostrava, Czech Republic.
Stroke Vasc Neurol. 2022 Apr;7(2):132-139. doi: 10.1136/svn-2021-001068. Epub 2021 Dec 1.
Carotid plaque progression contributes to increasing stroke risk. The study aims to identify factors influencing carotid plaque thickness progression after changing the preventive treatment to the 'treating arteries instead of risk factors' strategy, that is, change in treatment depending on the progression of atherosclerosis.
The study participants who completed sonographic controls over the course of 3 years were enrolled to the analysis. Duplex sonography of cervical arteries was performed in 6-month intervals with measurement of carotid plaque thickness. Plaque thickness measurement error (σ) was set as 3 SD. Only evidently stable and progressive plaques (defined as plaque thickness difference between initial and final measurements of ˂σ and >2σ, respectively) were included to analysis. Univariate and multivariate logistic regression analysis was performed to identify factors influencing plaque progression.
A total of 1391 patients (466 males, age 67.2±9.2 years) were enrolled in the study. Progressive plaque in at least one carotid artery was detected in 255 (18.3%) patients. Older age, male sex, greater plaque thickness, coronary heart disease, vascular surgery/stenting history and smoking were more frequently present in patients with progressive plaque (p˂0.05 in all cases). Multivariate logistic regression analysis identified only the plaque thickness (OR 1.850 for left side, 95% CI 1.398 to 2.449; and OR 1.376 for right side, 95% CI 1.070 to 1.770) as an independent factor influencing plaque progression.
Carotid plaque thickness corresponding to stenosis severity is the only independent risk factor for plaque thickness progression after optimising the prevention treatment.
NCT02360137.
颈动脉斑块进展会增加中风风险。本研究旨在确定在将预防治疗策略从“针对危险因素改为针对动脉”（即根据动脉粥样硬化进展改变治疗方法）后，影响颈动脉斑块厚度进展的因素。
本研究纳入了在 3 年内完成超声检查的患者。对颈总动脉进行了 6 个月一次的双功能超声检查，测量颈动脉斑块厚度。斑块厚度测量误差（σ）设定为 3 SD。仅纳入明显稳定和进展性斑块（定义为初始和最终测量之间的斑块厚度差异分别为＜σ和＞2σ）进行分析。采用单变量和多变量逻辑回归分析来确定影响斑块进展的因素。
共有 1391 例患者（466 例男性，年龄 67.2±9.2 岁）纳入本研究。在至少一条颈动脉中发现进展性斑块的患者有 255 例（18.3%）。年龄较大、男性、斑块厚度较大、冠心病、血管手术/支架史和吸烟的患者更常出现进展性斑块（p＜0.05）。多变量逻辑回归分析仅确定斑块厚度（左侧 OR 1.850，95%CI 1.398 至 2.449；右侧 OR 1.376，95%CI 1.070 至 1.770）是影响斑块进展的独立因素。
在优化预防治疗后，与狭窄严重程度相对应的颈动脉斑块厚度是斑块厚度进展的唯一独立危险因素。
NCT02360137。
