Key result
Carotid plaque formation was associated with an increased risk of developing cardiovascular disease, but this association was largely explained by cardiovascular risk factors and became non-significant after adjustment (adjusted HR for stroke 1.61 for plaque score >2 vs 0).
Why the study?
Does progression of carotid atherosclerosis predict incident cardiovascular disease in a Taiwanese community cohort?
Cohort (n=1,398)
No
Does progression of carotid atherosclerosis predict incident cardiovascular disease in a Taiwanese community cohort?
Hazard Ratio: 1.61 (95% CI 0.79–3.27)
Carotid plaque formation is associated with an increased risk of developing cardiovascular disease, but this association is largely explained by traditional cardiovascular risk factors.
Carotid atherosclerosis progression was associated with incident CVD in this Taiwanese cohort; extends Asian data but remains hypothesis-generating and should not yet change practice.
The authors investigated the association between progression of carotid atherosclerosis and incidence of cardiovascular disease in a community cohort in Taiwan. Data has rarely been reported in Asian populations. Study subjects were 1,398 participants who underwent ultrasound measures of common carotid artery intima-media thickness (IMT) and extracranial carotid artery plaque score at both 1994-1995 and 1999-2000 surveys. Cox proportional hazards model was used to assess the risk of incident cardiovascular disease. During a median follow-up of 13 years (1999-2013), 71 strokes and 68 coronary events occurred. The 5-year individual IMT change was not associated with development of cardiovascular events in unadjusted and adjusted models. Among subjects without plaque in 1994-1995, we observed elevated risk associated with presence of new plaque (plaque score >0 in 1999-2000) in a dose-response manner in unadjusted and age- and sex- adjusted models. The associations attenuated and became statistically non-significant after controlling for cardiovascular risk factors (hazard ratio [95% confidence interval] for plaque score >2 vs. 0: stroke, 1.61 [0.79-3.27], coronary events, 1.13 [0.48-2.69]). This study suggested that carotid plaque formation measured by ultrasound is associated increased risk of developing cardiovascular disease, and cardiovascular risk factors explain the associations to a large extent.
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Chen et al. (2016) conducted a cohort in Cardiovascular Disease Risk (n=1,398). Carotid atherosclerosis progression (new plaque formation and IMT change) vs. No progression / absence of new plaque was evaluated on Stroke (for plaque score >2 vs. 0, adjusted for cardiovascular risk factors) (HR 1.61, 95% CI 0.79-3.27). Carotid plaque formation was associated with an increased risk of developing cardiovascular disease, but this association was largely explained by cardiovascular risk factors and became non-significant after adjustment (adjusted HR for stroke 1.61 for plaque score >2 vs 0).
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