Subclinical Atherosclerosis Markers of Carotid Intima-Media Thickness, Carotid Plaques, Carotid Stenosis, and Mortality in Community-Dwelling Adults

Chuan-Wei Yang, Yuh-Cherng Guo, Chia-Ing Li, Chiu-Shong Liu, Chih-Hsueh Lin, Chung-Hsiang Liu, Mu-Cyun Wang, Shing-Yu Yang, Tsai-Chung Li and Cheng-Chieh Lin
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Chuan-Wei Yang: Department of Medical Research, China Medical University Hospital, Taichung 404, Taiwan
Yuh-Cherng Guo: Department of Neurology, China Medical University Hospital, Taichung 404, Taiwan
Chia-Ing Li: Department of Medical Research, China Medical University Hospital, Taichung 404, Taiwan
Chiu-Shong Liu: School of Medicine, College of Medicine, China Medical University, Taichung 404, Taiwan
Chih-Hsueh Lin: School of Medicine, College of Medicine, China Medical University, Taichung 404, Taiwan
Chung-Hsiang Liu: Department of Neurology, China Medical University Hospital, Taichung 404, Taiwan
Mu-Cyun Wang: School of Medicine, College of Medicine, China Medical University, Taichung 404, Taiwan
Shing-Yu Yang: Department of Public Health, College of Public Health, China Medical University, Taichung 404, Taiwan
Tsai-Chung Li: Department of Public Health, College of Public Health, China Medical University, Taichung 404, Taiwan
Cheng-Chieh Lin: School of Medicine, College of Medicine, China Medical University, Taichung 404, Taiwan

IJERPH, 2020, vol. 17, issue 13, 1-14

Abstract: Carotid intima–media thickness (IMT), plaque, and stenosis are widely used as early surrogate markers of subclinical atherosclerosis and strong predictors of future deaths and cardiovascular events. Albuminuria is an indicator of generalized endothelial dysfunction that speeds up atherosclerosis. However, previous studies reporting these associations cannot rule out the confounding effect of albuminuria. We aimed to examine the independent and joint relationships between IMT markers and 10-year mortality in community-dwelling Taiwanese adults. This work was a community-based prospective cohort study consisting of 2956 adults aged at least 30 years recruited in 2007 and followed up through 2019. Cox proportional hazard regression models were used to examine associations of these subclinical atherosclerosis markers with mortality. During an average of 9.41 years of follow up, 242 deaths occurred. The mortality rate was 8.70 per 1000 person-years. Compared with those with carotid IMT less than 1.0 mm, persons with severely increased carotid IMT (≥2.0 mm) had an increased risk for death (hazard ratio (HR): 1.79; 95% confidence interval (CI): 1.07, 3.00). Compared with those without carotid plaque, persons with carotid plaque were more likely to have an increased risk for death (1.65; 1.21–2.32). Compared with those with carotid stenosis less than 25%, persons with carotid stenosis of 25–36% had a significant increased risk for death (1.57; 1.12–2.22). Considering these three IMT markers along with the traditional risk factors (c-statistic: 0.85) significantly increased their predictive ability of mortality compared with any individual variable’s predictive ability (all p -values < 0.001 for comparisons of c-statistic values). Carotid IMT measures, including IMT thickness, carotid plaque, and carotid stenosis were significant independent predictors of mortality. Our study supports evidence of blood pressure-related media thickening markers to assess future mortality risks in Chinese adults of general population.

Keywords: intima–media thickness; plaque; stenosis; mortality (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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