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A Longitudinal Study of Carotid Plaque and Risk of Ischemic Cardiovascular Disease in the Chinese Population.
Xie, Wuxiang MDa; Wu, Yangfeng MD, PhDa,∗; Wang, Wei MDb; Zhao, Dong MDb; Liang, Lirong PhD, MDc; Wang, Miao MDb; Yang, Ying MDd; Sun, Jiayi MDb; Shi, Ping MDe; Huo, Yong MDd

Abstract

Background: The aim of this study was to investigate the role of carotid plaque in predicting ischemic cardiovascular risk, which has been intensively reported in Western populations but not yet in the Chinese population, in which the cardiovascular disease profile is significantly different.

Methods: Cox proportional-hazards regression was used to analyze associations between the presence of carotid plaque and the number of segments of carotid arteries with plaque (total plaque score) and the risk for subsequent ischemic cardiovascular disease (ICVD) events, including ischemic stroke and coronary heart disease, in 3,258 Chinese men and women aged 38 to 79 years at baseline. During 5 years of follow-up, 137 ICVD events were identified.

Results: The person-year incidence was 10.6 per 1,000 for ICVD, 6.7 per 1,000 for ischemic stroke, and 4.4 per 1,000 for coronary heart disease. After adjustment for conventional cardiovascular risk factors, the risk for ICVD was significantly associated with the presence of carotid plaque (hazard ratio, 1.49; 95% confidence interval [CI], 1.05–2.14) and total plaque score (hazard ratio per 1-score increase, 1.25; 95% CI, 1.04–1.50). Further analysis showed that the multivariate-adjusted hazard ratio of ICVD associated with plaque in common carotid arteries was 1.90 (95% CI, 1.15–3.13) and that with plaque in bifurcations was 1.26 (95% CI, 0.86–1.85). The results of separate analyses for ischemic stroke and coronary heart disease paralleled those for ICVD. The addition of total plaque score to the risk prediction model resulted in a significant improvement in risk estimation when measured by net reclassification improvement index.

Conclusions: Carotid plaque adds significant additional information for predicting the risk for ICVD events in the Chinese population.

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