颈总动脉直径与心血管疾病死亡率的关系：中国东北地区的一项前瞻性队列研究。

Common carotid artery diameter and the risk of cardiovascular disease mortality: a prospective cohort study in northeast China.

机构信息

Department of Ultrasound, The Fourth Affiliated Hospital of China Medical University, Shenyang, 110000, People's Republic of China.

Department of Ultrasound, The Affiliated Hospital of Northwest University, Xi'an No.3 Hospital, Xi'an, 710000, People's Republic of China.

出版信息

BMC Public Health. 2024 Jan 22;24(1):251. doi: 10.1186/s12889-024-17749-x.

DOI:10.1186/s12889-024-17749-x

PMID:38254061

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10801967/

Abstract

BACKGROUND

The association between the common carotid artery (CCA) diameter and cardiovascular disease (CVD) is recognized, but the precise nature of this link remains elusive. This study aimed to investigate the potential relationship between CCA diameter and the risk of CVD mortality in a large population in northeast China.

METHODS

The current study included 5668 participants (mean age 58.9 ± 10.1 years) from a population-based study conducted in rural areas of northeast China between September 2017 and May 2018. Information on death was collected from baseline until July 31, 2022. The CCA inter-adventitial diameter was measured using ultrasound. Cox proportional-hazard models were employed to explore the relationship between the common carotid artery diameter and cardiovascular mortality.

RESULTS

At baseline, the mean CCA diameter (mm) of subjects was 7.30 ± 0.99 and increased significantly with age, ranging from 6.65 ± 0.71 among people 40-49 years to 7.99 ± 1.04 among people ≥ 80 years. CCA diameter was significantly larger in males compared to females (7.51 ± 1.03 versus vs. 7.16 ± 0.94; P < 0.001). A total of 185 participants died of CVD during a median follow-up of 4.48 years. CCA diameters were divided into quartiles, and the highest quartile of carotid diameter (≥ 8.06 mm) had a 2.29 (95% confidence interval [CI]: 1.24, 4.22) times higher risk of CVD mortality than the lowest quartile (≤ 6.65 mm) (P < 0.01) in the fully adjusted model. Each increase in the diameter of the common carotid artery (per SD) raised the risk of cardiovascular death by 36% (hazard ratio [HR]: 1.36; 95% CI: 1.18, 1.57). The subgroup analysis results demonstrated that a per SD increase was associated with a 42% increased risk of CVD mortality in participants aged ≥ 64 years in the fully adjusted model (HR: 1.42; 95%CI: 1.21, 1.66).

CONCLUSIONS

Our study indicates the possible incremental value of CCA diameter in optimizing the risk stratification of cardiovascular disease and provides essential insights into reducing the burden of cardiovascular disease.

摘要

背景

普遍颈动脉（CCA）直径与心血管疾病（CVD）之间的关联已得到公认，但这种关联的精确性质仍难以捉摸。本研究旨在探讨在中国东北地区一个大型人群中，CCA 直径与 CVD 死亡率风险之间的潜在关系。

方法

本研究纳入了 2017 年 9 月至 2018 年 5 月在中国东北地区农村地区进行的一项基于人群的研究中的 5668 名参与者（平均年龄 58.9±10.1 岁）。从基线到 2022 年 7 月 31 日，收集死亡信息。使用超声测量 CCA 内中膜直径。采用 Cox 比例风险模型探讨CCA 直径与心血管死亡率之间的关系。

结果

在基线时，受试者的平均 CCA 直径（mm）为 7.30±0.99，且随年龄增长而显著增加，范围从 40-49 岁人群的 6.65±0.71 至≥80 岁人群的 7.99±1.04。男性的 CCA 直径明显大于女性（7.51±1.03 比 7.16±0.94；P<0.001）。在中位随访 4.48 年期间，共有 185 名参与者死于 CVD。CCA 直径分为四分位距，颈动脉直径最高四分位数（≥8.06mm）的 CVD 死亡率风险是最低四分位数（≤6.65mm）的 2.29 倍（95%置信区间[CI]：1.24，4.22）（P<0.01），在完全调整模型中。CCA 直径每增加一个标准差（per SD），心血管死亡风险增加 36%（风险比[HR]：1.36；95%CI：1.18，1.57）。亚组分析结果表明，在完全调整模型中，CCA 直径每增加一个 SD 与≥64 岁参与者 CVD 死亡率增加 42%相关（HR：1.42；95%CI：1.21，1.66）。