Incidence Of Carotid Atherosclerosis Research Articles

Sex-specific association between carotid atherosclerosis and fundus arteriosclerosis in a Chinese population: a retrospective cross-sectional study

ObjectivesVascular stiffening is highly predictive of major adverse cardiovascular events. It is not clear whether microangiopathy, such as fundus arteriosclerosis, is related to carotid atherosclerosis. Hence, this study was designed to investigate the relationship between carotid atherosclerosis and fundus arteriosclerosis among individuals of different sexes in the Chinese health-examination population.MethodsThis retrospective cross-sectional study involved 20,836 participants, including 13050 males and 7786 females. All participants underwent a detailed health examination, including medical history assessment, physical examination, assessment of lifestyle factors, fundus photography, Doppler ultrasound examination of the neck, and laboratory examinations. Two trained ophthalmologists analysed fundus arteriosclerosis based on fundus photographs, while carotid atherosclerosis was diagnosed using colour Doppler sonography of the neck. Binary logistic regression was used to analyse the relationship between carotid atherosclerosis and fundus arteriosclerosis.ResultsIn participants with fundus arteriosclerosis, the incidence of carotid atherosclerosis was higher than that of participants without fundus arteriosclerosis (52.94% vs. 47.06%). After adjustments for potential confounding factors, fundus arteriosclerosis was significantly associated with the risk of carotid atherosclerosis. The OR with 95% CI for fundus arteriosclerosis was 1.17 (1.02, 1.34) with p = 0.0262, and individuals who did not have fundus arteriosclerosis were used as a reference in the total population. Fundus arteriosclerosis was associated with the incidence of carotid atherosclerosis in males (p = 0.0005) but not in females (p = 0.0746).ConclusionsFundus arteriosclerosis was closely associated with carotid atherosclerosis in the Chinese population. This association was found in males but not in females.

Association between soft drink consumption and carotid atherosclerosis in a large-scale adult population: The TCLSIH cohort study

Background and aimsCarotid atherosclerosis indicates an increased risk for cardiac-cerebral vascular disease. Given the pattern of consumption in China, sugar-sweetened beverage is the main type of soft drink consumed. As soft drinks contain a high amount of fructose, they may be a risk factor of carotid atherosclerosis. A prospective cohort study was conducted to investigate the association between soft drink consumption and the incidence of carotid atherosclerosis in a Chinese adult population. Methods and resultsA total of 3828 participants (men: 2007 and women: 1821) were included. Carotid atherosclerosis was measured by using ultrasonography and was defined by increased carotid intima-media thickness and/or carotid plaques. Soft drink consumption was assessed using a validated food frequency questionnaire. Cox proportional hazards regression analysis was used to assess the association of soft drink consumption categories with the incidence of carotid atherosclerosis. During a mean follow-up of 3.20 years, 1009 individuals of the 3828 eligible participants developed carotid atherosclerosis. After adjusting for potential confounding factors, we compared the higher levels to the lowest level of soft drink consumption in women, and we estimated the multivariable hazard ratios and 95% confidence intervals of incident carotid atherosclerosis to be 1.09 (0.80, 1.50), and 1.56 (1.14, 2.13) (P for trend <0.05). However, there was no significant association between soft drink consumption and the incidence of carotid atherosclerosis in men or total population. ConclusionThe result indicated that soft drink consumption was associated with a higher incidence of carotid atherosclerosis in women. Trial registeredUMIN Clinical Trials Registry. Trial registration numberUMIN000027174. Trial registration websitehttps://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000031137.

Association of High Muscle Mass with Carotid Atherosclerosis: A Community-Based Population Cohort Study.

Although low muscle mass may make an under-appreciated contribution to increasing the risk of cardiovascular diseases, no prospective studies have explored the association between low muscle mass and carotid atherosclerosis. We investigated whether muscle mass was related to a higher carotid intima-media thickness (C-IMT) and carotid artery plaque in a community-based population. The study included 1,253 asymptomatic participants without known cardiovascular disease, who underwent carotid ultrasonography at baseline in 2013-2014 and received a re-examination in 2015-2016. The skeletal muscle mass index was estimated using a bioelectrical impedance analyzer. We assessed the relationship between the skeletal muscle mass index and the development of C-IMT and carotid plaque, both, using multivariate-adjusted logistic regression models. During the follow up, 400 (51.0%) subjects with normal C-IMT at baseline developed elevated C-IMT and 215 (17.2%) subjects developed carotid plaque. The risk of elevated C-IMT occurrence linearly decreased with an increase in skeletal muscle mass index quintiles or its continuous data, after multivariate-adjustment in men and women, respectively (both P for trend < 0.05; both P < 0.05). Subgroup analyses showed that this association was BMI-dependent. Besides, there was an inverse association between a high skeletal muscle mass index and carotid artery plaque in women, but the association disappeared after multivariate adjustment. In men, the skeletal muscle mass index was not associated with the incidence of carotid plaque. Skeletal muscle mass was inversely associated with the incidence of carotid atherosclerosis, suggesting muscle mass maintenance may play a role in modifying atherosclerosis.

Incidence of Carotid Atherosclerosis in Ischemic Stroke Detected by Duplex Ultrasound

Incidence of Carotid Atherosclerosis in Ischemic Stroke Detected by Duplex Ultrasound

Gender differences in the detection of carotid atherosclerosis: DUPLEX registry cross-sectional study results.

The aim of this study was to assess the features of detecting carotid atherosclerosis depending on gender, age, the presence of arterial hypertension, other major diseases and conditions according to The Duplex Registry Database. The registry sequentially included the results of duplex scanning of the carotid arteries (DSCA) of all patients who underwent it at the United Hospital with Outpatient Department in 2013 (n=2548). The incidence of carotid atherosclerosis (CAS) was higher in men than in women (58.6% (n=763) vs 45.5% (n=568), p<0.0000001). This was noted in all categories according to the gradation of stenosis, including in the category of the most severe lesion (>70%): 2.9% (n=32) vs 1.0% (n=13), p=0.003. The presence of CAD significantly increased the chances of detecting CAS in men (OR 4.47 vs 2.6, p<0.0000001). Signs more significant in their influence in women compared to men were the following: age (OR 5.3 [4.12; 6.71] p<0.0000001); arterial hypertension (OR 2.7 [2.12; 3.39] p<0.0000001) and cerebrovascular disease (OR 1.63 [1.13; 2.36] p=0.004). The OR of CAS detection for the "acute cerebrovascular accident" diagnosis in men and women differed 2 times (OR 1.2, p=0.4 vs 2.4, p=0.15). The "hypercholesterolemia" diagnosis when referred for DSCA did not show itself as a predictor of CAS detection in all study groups. Disorders of autonomic nervous system, hearing loss and screening examination showed a significant decrease in the probability of CAS detecting for the whole group (OR 0.14 [0.08;0.24] p<0.0000001; OR 0.16 [0.02;0.66] p=0.004 and OR 0.3 [0.25 0.37] p<0.0000001, respectively), so and separately for males and females. The present study revealed significant gender differences in the prevalence of carotid atherosclerosis and in the influence of various signs on an increase in the chances of its detection. The most significant signs were (OR men vs women): gender (1.3 vs 0.8), age (4.2 vs 5.3), arterial hypertension (1.8 vs 2.7), CAD (4.4 vs 2.6), cerebrovascular disease (1.26 vs 1.63).

Identification of Silent Myocardial Ischemia in Patients with Long-Term Type 1 and Type 2 Diabetes

(1) Background: This study aimed to analyze epidemiological data to identify risk factors for silent myocardial ischemia in patients with long-term type 1 and type 2 diabetes. (2) Methods: An analysis was performed on 104 patients with long-term type 1 and type 2 diabetes who had not previously been diagnosed with cardiovascular disease. During hospitalization, patients were subjected to a standard ECG exercise test on a treadmill. If the test could not be performed or the result was uncertain, a pharmacological exercise test with dobutamine was performed. In the case of a positive exercise ECG test or a positive dobutamine test, the patient underwent coronary angiography. (3) Results: Atherosclerotic lesions were found in 24 patients. Patients with silent ischemia were significantly older and had a lower mean left ventricular ejection fraction and a higher incidence of carotid atherosclerosis. The presence of microvascular complications did not increase the risk of silent ischemia. (4) Conclusions: Silent heart ischemia is more common in type 2 than type 1 diabetes. Predisposing factors include older age, coexistence of carotid atherosclerosis, lower left ventricular ejection fraction, and smoking in patients with type 1 diabetes. Concomitant microvascular complications are not a risk factor.

Helicobacter pylori infection selectively increases the risk for carotid atherosclerosis in young males

Background and aimsAtherosclerosis is an important contributing factor to cardiovascular mortality. The role of Helicobacter pylori (H. pylori) infection in atherosclerosis is inconsistent and sometimes controversial. The present study aimed to determine if H. pylori infection is associated with carotid atherosclerosis. Methods17,613 males and females with both carotid ultrasonic examination and 13C-urea breath test for H. pylori infection were screened by a major Chinese university hospital from March 2012 to March 2017 for the study. Baseline demographics, cardiac risk factors, and laboratory studies were obtained. After exclusion for pre-specified conditions, 12,836 individuals were included in the analysis, including 8157 men (63.5%) and 4679 women (36.5%). Analysis was also made for 5-year follow-up data of 1216 subjects (869 males and 347 females) with and without H. pylori infection for development and progression of carotid atherosclerosis. ResultsAfter adjusting for age, sex, body mass index, lipid profile, hypertension, renal function, diabetes mellitus, and smoking, H. pylori infection was found as an independent risk factor for carotid atherosclerosis in males under 50 years, but not in older males or females (odds ratio 1.229, 95% CI 1.054–1.434, p = 0.009). Follow-up data analysis showed that the incidence of carotid atherosclerosis from no atherosclerosis to detectable lesions was significantly higher in young males with persistent H. pylori infection than those without H. pylori infection (p = 0.028) after 3 years. ConclusionsThese data suggest that H. pylori infection might be an important risk factor for carotid atherosclerosis in young Chinese males under 50.

Association Between Erythrocyte Polyunsaturated Fatty Acids and Incidence of Metabolism Syndrome and Subclinical Carotid Atherosclerosis: A Population Prospective Study (OR19-08-19)

ObjectivesPrevious studies have suggested that polyunsaturated fatty acids (PUFAs) levels may be inversely associated with metabolism syndrome (MS) and atherosclerosis (AS). And yet, null results from recent long-term randomized clinical trials and meta-analysis threw an uncertainty to the cardioprotective benefits of n-3 and n-6 PUFAs. We prospectively examined the associations between erythrocyte PUFAs levels and MS and carotid AS and the intermediary effects of retinol-binding protein 4 (RBP4). MethodsThis prospective study recruited 4040 participants (40-75 years old) in 2008–2013. Follow-up examinations were performed every 3 years. We assessed erythrocyte PUFAs proportion at baseline and determined serum RBP4 at the first follow-up. The carotid intima-media thickness (IMT) at the common carotid artery (CCA) and bifurcation of the carotid artery (BIF) were measured by B-mode ultrasound at baseline and the first follow-up. ResultsA total of 2745 participants were included in the analysis. The multivariable adjusted hazards ratios (HRs) [95% confidence interval (CI)] of incidence of MS for the top (vs. lowest) tertile of erythrocyte PUFA were 0.71 (0.59, 0.86) (docosahexaenoic acid, DHA), 0.78 (0.65, 0.95) (docosapentaenoic acid, DPA) for n-3 PUFAs and 0.57 (0.47, 0.69) (arachidonic acid, ARA) and 0.75 (0.62, 0.91) (dodecylthioacetic acid, DTA) for n-6 PUFAs (all Ps trend < 0.05) during the 5.4-year follow-up. Similarly, erythrocyte DPA and DHA, ARA, DTA were significantly inversely and dose-dependently associated with incidence of carotid AS (Ptrend < 0.001 to 0.033). While a positive association of gamma-linolenic acid (GLA) was found with both incidence of MS and carotid AS. Pathway analyses indicated DHA and ARA to MS and AS associations were mediated by lowering serum RBP4, which were positively associated with MS and AS risk. ConclusionsHigher erythrocyte DPA, DHA (n-3 PUFA) and ARA, DTA (n-6 PUFA) but lower GLA were associated with incidence of MS and AS. Inverse association linking DHA, LA and ARA to incidence of MS and AS was mediated by reducing serum RBP4. Potential differences in the cardiovascular disease effects of different types of circulating PUFAs were suggested. Funding SourcesThis study was jointly supported by the National Natural Science Foundation of China (No. 81472965, 81730090, 81773416) and the 5010 Program for Clinical Researches (No. 2007032) by the Sun Yat-sen University, Guangzhou, P. R. China. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Supporting Tables, Images and/or Graphs▪▪▪▪

Analysis of the population at high risk of stroke detected with carotid artery ultrasonography in Tianjin urban communities

Objective To investigate the features of carotid atherosclerosis in a population at high risk of stroke in urban communities of Tianjin, so as to provide inspiration for carotid ultrasonography to play a greater role in the prevention and control of stroke. Methods A total of 956 residents at high risk of stroke were selected from 4 urban communities in Tianjin using cluster random sampling method. Doppler ultrasound screening was performed in bilateral common carotid artery (CCA), internal carotid artery (ICA), external carotid artery (ECA), vertebral artery (VA), subclavian artery (SCA) and innominate artery of the population. The intima-media thickness (IMT), atherosclerotic plaque formation and its location and size, vascular stenosis or occlusion, and flow spectrum were detected. The results and features of carotid ultrasound screening were analyzed and compared among different gender and age groups. Results 1) The detection rate of carotid atherosclerosis was 71.55% (684/956), and the detection rate in males was significantly higher than that in females (79.08% vs 65.87%; χ 2 = 20.067, P = 0.000). 2) Among the population with carotid atherosclerosis, the most common manifestation was the formation of atherosclerotic plaques (81.58%, 558/684), secondly intima-media thickening (13.01%, 89/684), followed by moderate to severe stenosis or occlusion (5.41%, 37/684). The proportion of intima-media thickening in males was lower than that in females (7.08% vs 18.38%; χ 2 = 19.269, P = 0.000). The proportion of carotid atherosclerotic plaque formation in males was higher than that in females (86.46% vs 77.16%; χ 2 = 9.824, P = 0.002). The median rating of carotid atherosclerosis was 1.79, with males higher than females [1.98 (0.70, 3.26) vs 1.52 (0.20, 2.84); Z = 2.304, P = 0.042]. The site of plaque formation was most commonly located in carotid bulb (36.61%), secondly SCA (22.18%). Of the type of carotid stenosis, ICA stenosis was detected in 30 cases, VA stenosis in 4 cases, VA occlusion in 3 cases, and subclavian steal syndrome (SSS) in 10 cases. 3) The detection rate of carotid atherosclerosis increased with age ( χ 2 = 212.067, P = 0.000). The detection rate of intima-media thickening in the population aged less than 70 years was higher than that aged over 70 years (10.68% vs 6.03% ; χ 2 = 5.101, P = 0.024). The detection rate of carotid atherosclerotic plaque of the population aged over 60 years was significantly higher than that aged less than 60 years (72.26% vs 28.99%; χ 2 = 64.850, P = 0.000). Similarly, the detection rate of moderate to severe stenosis or occlusion in the population aged over 60 years was significantly higher than that aged less than 60 years (5.24% vs 0.98%; χ 2 = 10.174, P = 0.001). Conclusions The incidence of carotid atherosclerosis in the population at high risk of stroke is high in urban communities of Tianjin, and the incidence of males is higher than that of females, increasing with age. It is an simple, non-invasive, accurate, reliable, and effective measure to prevent stroke by using carotid artery ultrasound screening in the population at high risk of stroke. DOI: 10.3969/j.issn.1672-6731.2015.04.005

Decision tree analysis of traditional risk factors of carotid atherosclerosis and a cutpoint-based prevention strategy.

BackgroundReducing the exposure to risk factors for the prevention of cardio-cerebral vascular disease is a crucial issue. Few reports have described practical interventions for preventing cardiovascular disease in different genders and age groups, particularly detailed and specific cutpoint-based prevention strategies.MethodsWe collected the health examination data of 5822 subjects between 20 and 80 years of age. The administration of medical questionnaires and physical examinations and the measurement of blood pressure, fasting plasma glucose (FPG) and blood lipids [total cholesterol (TC), triglycerides (TG), high density lipoprotein–cholesterol (HDL-C), and low density lipoprotein-cholesterol (LDL-C)] were performed by physicians. Carotid ultrasound was performed to examine the carotid intima-media thickness (CIMT), which was defined as carotid atherosclerosis when CIMT ≥0.9 mm. Decision tree analysis was used to screen for the most important risk factors for carotid atherosclerosis and to identify the relevant cutpoints.ResultsIn the study population, the incidence of carotid atherosclerosis was 12.20% (men: 14.10%, women: 9.20%). The statistical analysis showed significant differences in carotid atherosclerosis incidence between different genders (P<0.0001) and age groups (P<0.001). The decision tree analysis showed that in men, the most important traditional risk factors for carotid atherosclerosis were TC (cutpoint [CP]: 6.31 mmol/L) between the ages of 20–40 and FPG (CP: 5.79 mmol/L) between the ages of 41–59. By comparison, LDL-C (CP: 4.27 mmol/L) became the major risk factor when FPG ≤5.79 mmol/L. FPG (CP: 5.52 mmol/L) and TG (CP: 1.51 mmol/L) were the most important traditional risk factors for women between 20–40 and 41–59 years of age, respectively.ConclusionTraditional risk factors and relevant cutpoints were not identical in different genders and age groups. A specific gender and age group-based cutpoint strategy might contribute to preventing cardiovascular disease.

Significance of carotid ultrasonography in patients with paroxysmal supraventricular tachycardia and hypertension

Objective To explore the significance of carotid ultrasonography in patients with paroxysmal supraventricular tachycardia and hypertension.Methods 120 cases of paroxysmal supraventricular tachycardia and hypertension underwent high-frequency color Doppler ultrasound to measure carotid artery diameter and intima-media thickness (IMT).Selected 113 cases of simple hypertension as the control group.Results Incidences of carotid artery plaque and thickening IMT of patients with paroxysmal supraventricular tachycardia and hypertension were 82.5％ and 75.4％ respectively,significantly higher than 30.7％ and 41.3％of the control group (P ＜ 0.05).Left and right IMT of patients with paroxysmal supraventricular tachycardia and hypertension were (0.96 ± 0.13) mm and (0.98 ± 0.10) mm,significantly different from (0.68 ± 0.07) mm and (0.70 ± 0.08) mm of the control group (P ＜ 0.01).Left and right carotid artery diameter of patients with paroxysmal supraventricular tachycardia and hypertension were (0.77 ± 0.12) mm and (0.73 ± 0.10) mm,those of the control group were (0.68 ± 0.06) mm and (0.69 ± 0.07) mm,without statistically significant difference (P ＞ 0.05).Conclusion The incidence of carotid atherosclerosis in patients with paroxysmal supraventricular tachycardia and hypertension increased. Key words: Carotid ultrasonic examination; Paroxysmal supraventricular tachycardia; Hypertension

Genetic Profiling Using Genome-Wide Significant Coronary Artery Disease Risk Variants Does Not Improve the Prediction of Subclinical Atherosclerosis: The Cardiovascular Risk in Young Finns Study, the Bogalusa Heart Study and the Health 2000 Survey – A Meta-Analysis of Three Independent Studies

BackgroundGenome-wide association studies (GWASs) have identified a large number of variants (SNPs) associating with an increased risk of coronary artery disease (CAD). Recently, the CARDIoGRAM consortium published a GWAS based on the largest study population so far. They successfully replicated twelve already known associations and discovered thirteen new SNPs associating with CAD. We examined whether the genetic profiling of these variants improves prediction of subclinical atherosclerosis – i.e., carotid intima-media thickness (CIMT) and carotid artery elasticity (CAE) – beyond classical risk factors.Subjects and MethodsWe genotyped 24 variants found in a population of European ancestry and measured CIMT and CAE in 2001 and 2007 from 2,081, and 2,015 subjects (aged 30–45 years in 2007) respectively, participating in the Cardiovascular Risk in Young Finns Study (YFS). The Bogalusa Heart Study (BHS; n = 1179) was used as a replication cohort (mean age of 37.5). For additional replication, a sub-sample of 5 SNPs was genotyped for 1,291 individuals aged 46–76 years participating in the Health 2000 population survey. We tested the impact of genetic risk score (GRS24SNP/CAD) calculated as a weighted (by allelic odds ratios for CAD) sum of CAD risk alleles from the studied 24 variants on CIMT, CAE, the incidence of carotid atherosclerosis and the progression of CIMT and CAE during a 6-year follow-up.ResultsCIMT or CAE did not significantly associate with GRS24SNP/CAD before or after adjusting for classical CAD risk factors (p>0.05 for all) in YFS or in the BHS. CIMT and CAE associated with only one SNP each in the YFS. The findings were not replicated in the replication cohorts. In the meta-analysis CIMT or CAE did not associate with any of the SNPs.ConclusionGenetic profiling, by using known CAD risk variants, should not improve risk stratification for subclinical atherosclerosis beyond conventional risk factors among healthy young adults.

Association of serum uric acid and lipid with carotid atherosclerosis in hypertension patients

Objective The aim of the present study was to determine the associations between uric acid,lipid and carotid atherosclerosis in the hypertension patients.Methods Eighty participants with essential hypertension were enrolled to undergo by uhrasonography to calculate intima-media thickness (IMT) and carotid artery plaques,each participants were detected UA,serum lipids.Results Multiple regression analysis revealed the UA,TG,LDLC was significantly independently associated with IMT (P＜0.01) in non-plaques participants.UA,LDL-C in the group of carotid atherosclerotic were significantly higer than the group of the normal I MT.Condusion UA,TG,LDL-C were found to be an independent risk factor for incidence of carotid atherosclerosis. Key words: Hypertension; Atherosclerosis; Uric acid ; Carotid artery ; Dyslipidemias

Association of LDL cholesterol with carotid atherosclerosis in menopausal women affected by the metabolic syndrome

The metabolic syndrome is a highly prevalent condition associated with cardiovascular disease. However, the contribution of LDL to cardiovascular risk is not estimated since it is not part of ATP III criteria. This is an observational study evaluating the association between metabolic syndrome and carotid atherosclerosis, according to LDL cholesterol levels. Two hundred and sixty-five menopausal women were consecutively enrolled, they all underwent clinical examination, biochemical characterization and ultrasound evaluation. In particular, carotid atherosclerosis, a well known marker of cardiovascular disease, was evaluated. Women affected by cardiovascular disease were excluded from the study. The metabolic syndrome was found strongly associated with carotid atherosclerosis in our study population. In individuals with normal or near normal LDL, the incidence of carotid atherosclerosis was significantly lower than in subject with high LDL. A high plasma LDL concentration was independently associated with carotid atherosclerosis (p=0.026) among women with the metabolic syndrome. High LDL cholesterol levels are associated with carotid atherosclerosis in menopausal women with the metabolic syndrome. Although it remains prudent to recommend an integrated control of all modifiable risk factors to prevent cardiovascular disease, decreasing LDL levels should be considered a high priority.

Research in Heart Disease

Research in Heart Disease