Key result
Highest neck circumference quartile linked to ~80% greater CHD risk compared to the lowest.
Why the study?
Coronary heart disease remains a leading cause of mortality globally and is increasingly prevalent in China, prompting investigation into whether neck circumference and the atherogenic index of plasma associate with disease severity and offer diagnostic utility.
Do neck circumference and atherogenic index of plasma correlate with the incidence and severity of coronary heart disease in patients with chest pain undergoing coronary angiography?
Cross-Sectional (n=1,652)
No
Do neck circumference and atherogenic index of plasma correlate with the incidence and severity of coronary heart disease in patients with chest pain undergoing coronary angiography?
Effect estimate: OR 1.80 (95% CI 1.22-2.66)
p-value: p=0.030
Neck circumference and atherogenic index of plasma are positively correlated with the incidence and severity of coronary heart disease, and their combined measurement provides significant predictive value.
Does not support routine neck circumference use in chest pain; leaves open incremental value in prospective risk models.
Background and aims Coronary heart disease (CHD) remains a leading cause of mortality globally and is becoming increasingly prevalent in China. Growing evidence suggests that dyslipidemia plays a critical role in the pathogenesis of atherosclerosis. The primary objective of this study was to investigate the association between neck circumference (NC) and the atherogenic index of plasma (AIP) with the severity of CHD, and to evaluate the diagnostic utility of combining NC with AIP for identifying CHD. Methods This observational, cross-sectional study included 1652 patients with chest pain from the Department of Cardiology at Chengde Central Hospital who underwent coronary angiography (CAG). Restricted cubic splines (RCS) were used to examine the associations between NC, AIP, and CHD. Independent predictors of CHD risk were identified through univariate and multivariate regression analyses and subsequently integrated into a risk prediction nomogram. The model’s performance was validated using receiver operating characteristic (ROC) curve, calibration plots, and decision curve analysis (DCA). Results The study demonstrates a robust association between NC and AIP with both the incidence and severity of CHD. After adjusting for sex and age, the ORs (95% CIs) for CHD increased progressively across the quartiles of NC: ORs were 1.24 (0.89-1.74), 1.42 (0.98-2.04), and 1.80 (1.22-2.66) for the second, third, and fourth quartiles, respectively, compared with the first quartile, indicating a significant increasing trend ( p- trend = 0.030). The ORs for the severity of coronary lesions across higher NC quartile were 1.22 (0.89-1.65), 1.38 (1.00-1.90), and 1.41 (1.02-1.95), relative to the lowest quartile ( p- trend = 0.039). The RCS curve demonstrated a significant positive linear relationship between NC, AIP, and CHD. The predictive accuracy of the nomogram model for CHD was substantial, evidenced by an area under the curve (AUC) of reaching 0.729 (95% CI 0.697-0.761, p < 0.001). Conclusions NC and AIP are positively correlate with CHD. Combined measurement of these variables provides significant predictive value for the diagnosis of CHD.
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Yang et al. (2025) conducted a cross-sectional in Coronary heart disease (n=1,652). Neck circumference (highest quartile) vs. Neck circumference (lowest quartile, <35.50 cm) was evaluated on Incidence of coronary heart disease (OR 1.80, 95% CI 1.22-2.66, p=0.030). Higher neck circumference was significantly associated with an increased risk of coronary heart disease, with patients in the highest quartile having an 80% greater risk compared to the lowest quartile (OR 1.80).
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