Bilateral common carotid artery ultrasound for prediction of incident strokes using intima-media thickness and external diameter: an observational study.
Cardiovasc Ultrasound
; 11: 22, 2013 Jun 15.
Article
em En
| MEDLINE
| ID: mdl-23768019
ABSTRACT
BACKGROUND:
External common carotid artery (CCA) diameter and intima-media thickness (IMT) are independently associated with incident stroke and other cardiovascular events. Arterial geometry such as large IMT and large diameter may reflect vulnerable plaques and so impact stroke risk. Finally, arterial changes that exist bilaterally may increase stroke risk.METHOD:
We studied middle-aged men and women (n=7276) from a prospective observational study who had right (R) and left (L) CCA IMT and external diameters measured via B-mode ultrasound (1987-89) in order to categorize CCA geometry. Using side- and gender-specific IMT and diameter medians, we categorized each measurement as large (≥ median) vs. not large (< median) and defined four geometries both IMT and diameter were large, only one parameter was large, or neither was large (reference group). Participants were followed for first time stroke through December 31, 1999. We used proportional hazards models to assess associations between right and left CCA geometries with new stroke. We also calculated positive and negative likelihood ratios (+LR and -LR) for CCA bilateral phenotypes as a measure of diagnostic accuracy.RESULTS:
Presence of both large CCA IMT and large diameter on one side was associated with strong stroke risk even after risk factor adjustment (men RCCA hazard ratio [HR]=3.7 95% confidence interval [CI]=1.9-7.4; LCCA HR=2.4 95% CI=1.4-4.4; women RCCA HR=4.0 95% CI=1.5-10.5; LCCA HR=5.7 95% CI=1.7-19.0). Presence of both large IMT and large diameter bilaterally was the strongest predictor of stroke identifying 64% of women and 44% of men who developed strokes. This phenotype showed potential for predicting stroke among individuals (women +LR=3.1, 95% CI=2.6-3.8; men +LR=2.3, 95% CI=1.8-2.8).CONCLUSION:
Bilateral carotid artery geometries may be useful for stroke risk prediction.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Ecocardiografia
/
Interpretação de Imagem Assistida por Computador
/
Artéria Carótida Primitiva
/
Acidente Vascular Cerebral
/
Espessura Intima-Media Carotídea
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Cardiovasc Ultrasound
Assunto da revista:
ANGIOLOGIA
/
CARDIOLOGIA
/
DIAGNOSTICO POR IMAGEM
Ano de publicação:
2013
Tipo de documento:
Article
País de afiliação:
Estados Unidos