Abstract P401: The Progress of Carotid Atherosclerosis is Associated With Incident Stroke and Coronary Heart Disease: The Suita Study

Abstract

Background and Purpose: We observed that the maximum of intima-media thickness (IMT) more than 1.1 mm in the common carotid artery (CCA), i.e. CIMT-plaque, is the best predictive marker for incident cardiovascular disease (CVD) in the Suita Study. There has been no study of the association between the progress of carotid atherosclerosis and CVD in a general population. We assessed our hypothesis that CIMT-plaque progression could predict the risk of new-onset CVD in a general population. Methods: We studied 3,722 men and women (mean age 59.8 years without CIMT-plaque or CVD at baseline) who completed a baseline survey and carotid ultrasonography. CIMT-plaque was defined as a maximum IMT in the CCA more than 1.1 mm. During the follow-up periods from April 1994 to March 2005, we observed 632 new CIMT-plaques. After new incident CIMT-plaque or as of April 2005, we conducted a prospective cohort study of the cases until the December 2013 endpoint. We compared the CVD risk by a Cox proportional hazards model after adjusting for age, sex, body mass index, prehypertension, hypertension (grades I and II+III), TC, HDL, antihypertensive drug and/or statin use, diabetes, impaired fasting glucose, chronic kidney disease, smoking, and excessive drinking (more than 4 units/day). Results: After new incident CIMT-plaques in CCA, we observed 234 incident CVD events (139 strokes and 95 coronary heart disease [CHD]) during 38,243 person-years of follow-up. Age, men, hypertension grades I and II+III, diabetes, and hypercholesterolemia were associated with the progression of CIMT-plaque. After new incident CIMT-plaques, the adjusted hazard ratios (95% confidence intervals) for CVD, stroke, and IHD during follow-up were 1.58 (1.15 to 2.17), 1.54 (1.03 to 2.31), and 1.72 (1.03 to 2.88). Conclusions: The novel finding of this study is that CIMT-plaque progression could be a good predictor of new-onset CVD in a general population.