Medical School of Chinese PLA.
Department of Cardiology, the Sixth Medical Centre.
J Thorac Imaging. 2023 Mar 1;38(2):113-119. doi: 10.1097/RTI.0000000000000655. Epub 2022 May 4.
To investigate the incremental value of noncontrast chest computed tomography (CT)-derived parameters, such as coronary artery calcium score (CACS) and epicardial adipose tissue volume (EATv), in predicting subclinical carotid atherosclerosis above traditional risk factors in community-based asymptomatic populations of northern China.
A total of 2195 community-based asymptomatic individuals were enrolled from Jidong Oilfield in accordance with the PERSUADE study. CACS and EATv were measured on noncontrast chest CT. Demographics and ideal cardiovascular health score (ICHS) were collected through questionnaires. We recalculated the ideal cardiovascular health risk score (ICHRS) (ICHRS=14-ICHS) and standardized the parameters as log-CACS and body mass index adjusted EATv (i-EATv). Subclinical carotid atherosclerosis was assessed by Doppler sonography and defined as any prevalence of average carotid intima-media thickness ≥1.00 mm, appearance of carotid plaque, and carotid arterial stenosis in the areas of extracranial carotid arteries on both sides.
A total of 451 (20.55%) individuals presented subclinical carotid atherosclerosis. CACS and EATv were significantly greater in the subclinical group, while ICHS was lower. In multivariate logistic regression, ICHRS (odds ratio [OR]=1.143, 95% confidence interval [CI]: 1.080-1.210, P <0.001), log-CACS (OR=1.701, 95% CI: 1.480-1.955, P <0.001), and i-EATv (OR=1.254, 95% CI: 1.173-1.341, P <0.001) were found to be independent risk predictors for subclinical carotid atherosclerosis. In receiver-operating characteristic curve analysis, when combined with male sex and age level, the area under the curve of the ICHRS basic model increased from 0.627 (95% CI: 0.599-0.654) to 0.757 (95% CI: 0.732-0.781) ( P <0.0001). Further adding log-CACS and i-EATv, the area under the curve demonstrated a statistically significant improvement (0.788 [95% CI: 0.765-0.812] vs. 0.757 [95% CI: 0.732-0.781], P <0.0001).
Noncontrast chest CT-derived parameters, including CACS and EATv, could provide significant incremental improvement for predicting subclinical carotid atherosclerosis beyond the conventional risk assessment model based on ICHRS.
探讨非对比胸部 CT 衍生参数（如冠状动脉钙评分[CACS]和心外膜脂肪组织体积[EATv]）在预测中国北方社区无症状人群亚临床颈动脉粥样硬化方面的附加价值，这些人群基于传统危险因素。
根据 PERSUADE 研究，共纳入了来自冀东油田的 2195 名社区无症状个体。在非对比胸部 CT 上测量 CACS 和 EATv。通过问卷调查收集人口统计学和理想心血管健康评分（ICHS）。我们重新计算了理想心血管健康风险评分（ICHRS）（ICHRS=14-ICHS）并将参数标准化为对数-CACS 和体重指数调整的心外膜脂肪组织体积（i-EATv）。通过多普勒超声评估亚临床颈动脉粥样硬化，并定义为任何双侧颈外动脉区域平均颈动脉内膜中层厚度≥1.00mm、颈动脉斑块出现和颈动脉狭窄的患病率。
共有 451 名（20.55%）个体存在亚临床颈动脉粥样硬化。亚临床组的 CACS 和 EATv 明显较高，而 ICHS 较低。在多变量逻辑回归中，ICHRS（比值比[OR]=1.143，95%置信区间[CI]：1.080-1.210，P<0.001）、log-CACS（OR=1.701，95%CI：1.480-1.955，P<0.001）和 i-EATv（OR=1.254，95%CI：1.173-1.341，P<0.001）被发现是亚临床颈动脉粥样硬化的独立危险因素。在受试者工作特征曲线分析中，当结合男性和年龄水平时，ICHRS 基本模型的曲线下面积从 0.627（95%CI：0.599-0.654）增加到 0.757（95%CI：0.732-0.781）（P<0.0001）。进一步加入 log-CACS 和 i-EATv，曲线下面积显示出统计学上的显著改善（0.788[95%CI：0.765-0.812] vs. 0.757[95%CI：0.732-0.781]，P<0.0001）。
非对比胸部 CT 衍生参数，包括 CACS 和 EATv，在预测中国北方社区无症状人群亚临床颈动脉粥样硬化方面，可以提供基于 ICHRS 的传统风险评估模型之外的显著附加价值。
