Common Carotid Artery Stenosis Degree as a Predictor of Cardiovascular Disease in a General Population: The Suita Study
Background The utility of screening for the degree of common carotid artery (CCA) stenosis as a predictor of cardiovascular disease (CVD) in a general population remains unclear. Methods and Results We studied 4775 Japanese men and women whose CCA was measured using bilateral carotid ultrasonography...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2024-01-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.123.030828 |
| _version_ | 1797229337041174528 |
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| author | Masayuki Teramoto Yoshihiro Kokubo Ahmed Arafa Rena Kashima Yoko M. Nakao Haytham A. Sheerah Hiroharu Kataoka |
| author_facet | Masayuki Teramoto Yoshihiro Kokubo Ahmed Arafa Rena Kashima Yoko M. Nakao Haytham A. Sheerah Hiroharu Kataoka |
| author_sort | Masayuki Teramoto |
| collection | DOAJ |
| description | Background The utility of screening for the degree of common carotid artery (CCA) stenosis as a predictor of cardiovascular disease (CVD) in a general population remains unclear. Methods and Results We studied 4775 Japanese men and women whose CCA was measured using bilateral carotid ultrasonography at baseline (April 1994–August 2001). We calculated the degree of stenosis as a percentage of the stenotic area of the lumen in the cross‐section perpendicular to the long axis. The Cox proportional hazards model was used to calculate multivariable‐adjusted hazard ratios (HRs) with 95% CIs for incident CVD and its subtypes according to the degree of CCA stenosis. During the median 14.2 years of follow‐up, 385 incident CVD events (159 coronary heart disease and 226 stroke) were documented. The degree of CCA stenosis was associated with increased risks of incident CVD, coronary heart disease, and stroke, with multivariable‐adjusted HRs (95% CIs) for <25%, 25%–49%, and ≥50% stenosis with plaque compared with no CCA plaque of 1.37 (1.07–1.76), 1.72 (1.23–2.40), and 2.49 (1.69–3.67), respectively. Adding the CCA stenosis degree to traditional CVD risk factors increased Harrell's C statistics (0.772 [95% CI, 0.751–0.794] to 0.778 [95% CI, 0.758–0.799]; P=0.04) and improved the 10‐year risk prediction ability (integrated discrimination improvement, 0.0129 [95% CI, 0.0078–0.0179]; P<0.001; continuous net reclassification improvement, 0.1598 [95% CI, 0.0297–0.2881]; P=0.01). Conclusions The degree of CCA stenosis may be used as a predictive marker for the development of CVD in the general population. |
| first_indexed | 2024-03-08T13:50:36Z |
| format | Article |
| id | doaj.art-c0f11bd3942a43929646ceebbef8246e |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-24T15:10:59Z |
| publishDate | 2024-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-c0f11bd3942a43929646ceebbef8246e2024-04-02T11:32:06ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802024-01-0113110.1161/JAHA.123.030828Common Carotid Artery Stenosis Degree as a Predictor of Cardiovascular Disease in a General Population: The Suita StudyMasayuki Teramoto0Yoshihiro Kokubo1Ahmed Arafa2Rena Kashima3Yoko M. Nakao4Haytham A. Sheerah5Hiroharu Kataoka6Department of Preventive Cardiology National Cerebral and Cardiovascular Center Suita JapanDepartment of Preventive Cardiology National Cerebral and Cardiovascular Center Suita JapanDepartment of Preventive Cardiology National Cerebral and Cardiovascular Center Suita JapanDepartment of Preventive Cardiology National Cerebral and Cardiovascular Center Suita JapanLeeds Institute of Cardiovascular and Metabolic Medicine University of Leeds Leeds United KingdomDepartment of Preventive Cardiology National Cerebral and Cardiovascular Center Suita JapanDepartment of Neurosurgery National Cerebral and Cardiovascular Center Suita JapanBackground The utility of screening for the degree of common carotid artery (CCA) stenosis as a predictor of cardiovascular disease (CVD) in a general population remains unclear. Methods and Results We studied 4775 Japanese men and women whose CCA was measured using bilateral carotid ultrasonography at baseline (April 1994–August 2001). We calculated the degree of stenosis as a percentage of the stenotic area of the lumen in the cross‐section perpendicular to the long axis. The Cox proportional hazards model was used to calculate multivariable‐adjusted hazard ratios (HRs) with 95% CIs for incident CVD and its subtypes according to the degree of CCA stenosis. During the median 14.2 years of follow‐up, 385 incident CVD events (159 coronary heart disease and 226 stroke) were documented. The degree of CCA stenosis was associated with increased risks of incident CVD, coronary heart disease, and stroke, with multivariable‐adjusted HRs (95% CIs) for <25%, 25%–49%, and ≥50% stenosis with plaque compared with no CCA plaque of 1.37 (1.07–1.76), 1.72 (1.23–2.40), and 2.49 (1.69–3.67), respectively. Adding the CCA stenosis degree to traditional CVD risk factors increased Harrell's C statistics (0.772 [95% CI, 0.751–0.794] to 0.778 [95% CI, 0.758–0.799]; P=0.04) and improved the 10‐year risk prediction ability (integrated discrimination improvement, 0.0129 [95% CI, 0.0078–0.0179]; P<0.001; continuous net reclassification improvement, 0.1598 [95% CI, 0.0297–0.2881]; P=0.01). Conclusions The degree of CCA stenosis may be used as a predictive marker for the development of CVD in the general population.https://www.ahajournals.org/doi/10.1161/JAHA.123.030828carotid stenosiscarotid ultrasonographycohort studycoronary heart diseasestroke |
| spellingShingle | Masayuki Teramoto Yoshihiro Kokubo Ahmed Arafa Rena Kashima Yoko M. Nakao Haytham A. Sheerah Hiroharu Kataoka Common Carotid Artery Stenosis Degree as a Predictor of Cardiovascular Disease in a General Population: The Suita Study Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease carotid stenosis carotid ultrasonography cohort study coronary heart disease stroke |
| title | Common Carotid Artery Stenosis Degree as a Predictor of Cardiovascular Disease in a General Population: The Suita Study |
| title_full | Common Carotid Artery Stenosis Degree as a Predictor of Cardiovascular Disease in a General Population: The Suita Study |
| title_fullStr | Common Carotid Artery Stenosis Degree as a Predictor of Cardiovascular Disease in a General Population: The Suita Study |
| title_full_unstemmed | Common Carotid Artery Stenosis Degree as a Predictor of Cardiovascular Disease in a General Population: The Suita Study |
| title_short | Common Carotid Artery Stenosis Degree as a Predictor of Cardiovascular Disease in a General Population: The Suita Study |
| title_sort | common carotid artery stenosis degree as a predictor of cardiovascular disease in a general population the suita study |
| topic | carotid stenosis carotid ultrasonography cohort study coronary heart disease stroke |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.123.030828 |
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