Carotid Intima Media Thickness and Plaques Can Predict the Occurrence of Ischemic Cerebrovascular Events
| Autor: | Marco Casaroli, Luigi Canciani, Pierre-Jean Touboul, Diego Vanuzzo, Giovanni Bader, Sergio Castellani, Patrizio Prati, Alberto Tosetto |
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| Rok vydání: | 2008 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Carotid Artery Common Population Ischemia Brain Ischemia Cohort Studies Predictive Value of Tests Risk Factors Internal medicine Diabetes Mellitus medicine Humans Carotid Stenosis cardiovascular diseases education Stroke Aged Ultrasonography Aged 80 and over Advanced and Specialized Nursing education.field_of_study Framingham Risk Score Receiver operating characteristic business.industry Age Factors Middle Aged Prognosis medicine.disease Surgery Italy Intima-media thickness Cohort Disease Progression cardiovascular system Cardiology Female Neurology (clinical) Cardiology and Cardiovascular Medicine business Cohort study |
| Zdroj: | Stroke. 39:2470-2476 |
| ISSN: | 1524-4628 0039-2499 |
| DOI: | 10.1161/strokeaha.107.511584 |
| Popis: | Background and Purpose— The clinical usefulness of noninvasive measurement of carotid intima media thickness and plaque visualization in the general population is still uncertain. Methods— We evaluated the age-specific incidence rates of cerebrovascular events in a cohort of 1348 subjects randomly taken from the census list of San Daniele Township and followed for a mean period of 12.7 years. The association among common carotid intima media thickness, measured at baseline, arterial risk factors, and incidence of ischemic cerebrovascular events was modeled using Poisson regression. The predictive ability of common carotid intima media thickness over arterial risk factors (summarized in the Framingham Stroke Risk Score) was evaluated by receiver operating characteristic curve analysis. Results— During the follow-up, 115 subjects developed nonfatal ischemic stroke, transient ischemic attack, or vascular death, which were the predefined study end points. After adjustment for age and sex, hypertension, diabetes, common carotid intima media thickness above 1 mm, and carotid plaques were all independent risk factors for development of vascular events. Inclusion of carotid findings (presence of common carotid intima media thickness above 1 mm or carotid plaques) resulted in a predictive power higher than Framingham Stroke Risk Score alone only on for those subjects with a Framingham Stroke Risk Score over 20%. Conclusions— Although common carotid intima media thickness and presence of carotid plaques are known to be risk factors for the development of vascular events and to be independent from the conventional risk factors summarized in the Framingham Stroke Risk Score, their contribution to individual risk prediction is limited. Further studies will be required to address the role of carotid ultrasonography in the primary prevention of high-risk subjects. |
| Databáze: | OpenAIRE |
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