Associations of Carotid Intima‐Media Thickness and Plaque Heterogeneity With the Risks of Stroke Subtypes and Coronary Artery Disease in the Japanese General Population: The Circulatory Risk in Communities Study

Abstract

Background Evidence on the associations of carotid intima‐media thickness and carotid plaque characteristics with stroke subtypes and coronary artery disease risks in Asians is limited. This study investigated these associations in the Japanese general population. Methods and Results Maximum intima‐media thicknesses of both the common carotid artery and internal carotid artery and carotid plaque characteristics were evaluated in 2943 Japanese subjects aged 40 to 75 years without history of cardiovascular disease. Subjects were followed up for a median of 15.1 years. Using a multivariate Cox proportional hazard model, we found that hazard ratios (HRs) and 95% CIs for the highest (≥1.07 mm) versus lowest (≤0.77 mm) quartiles of maximum intima‐media thicknesses of the common carotid artery were 1.97 (1.26–3.06) for total stroke, 1.52 (0.67–3.41) for hemorrhagic stroke, 2.45 (1.41–4.27) for ischemic stroke, 3.60 (1.64–7.91) for lacunar infarction, 1.53 (0.69–3.41) for nonlacunar cerebral infarction, 2.68 (1.24–5.76) for coronary artery disease, and 2.11 (1.44–3.12) for cardiovascular disease (similar results were found for maximum intima‐media thicknesses of the internal carotid artery). HRs(95% CIs) for heterogeneous plaque versus no plaque were 1.58 (1.09–2.30) for total stroke, 1.25 (0.58–2.70) for hemorrhagic stroke, 1.74 (1.13–2.67) for ischemic stroke, 1.84 (1.03–3.19) for lacunar infarction, 1.58 (0.80–3.11) for nonlacunar cerebral infarction, 2.11 (1.20–3.70) for coronary artery disease, and 1.71 (1.25–2.35) for cardiovascular disease. Conclusions Maximum intima‐media thicknesses of the common carotid artery, maximum intima‐media thicknesses of the internal carotid artery, and heterogeneous plaque were associated with the risks of stroke, lacunar infarction, coronary artery disease, and cardiovascular disease in Asians.

Combined effect of inter-arm systolic blood pressure difference and carotid artery plaque on cardiovascular diseases and mortality: A prospective cohort study

“…Carotid plaque is considered a surrogate marker of subclinical atherosclerosis and is associated with the risk of stroke, MI, and mortality ( 2 , 3 , 20 ). In the present results, we found that carotid artery plaque significantly increased the risk of all-cause mortality by 1.73 times in the general Chinese population.…”

“…Carotid artery plaque is a marker of degenerative changes and structural changes in atherosclerosis. The previous study shows that the presence of carotid plaque is associated with the risk of stroke, myocardial infarction (MI), and mortality ( 2 , 3 ). Meta-analysis shows that carotid plaque is also a better predictor of future cardiovascular events than the intima-media thickness ( 4 ).…”

The Association of Lung Function and Carotid Intima-Media Thickness in a Japanese Population: The Tohoku Medical Megabank Community-Based Cohort Study

“…Many previous studies have reported that lung function is inversely associated with cIMT [10][11][12][13][14][15][16][17][18] . However, studies demonstrating the association between lung function and cIMT among never smokers are limited 13,[15][16][17] .…”

“…Previous studies have reported that lower lung function is related to an increased risk of coronary heart disease (CHD), stroke, and CVD [2][3][4][5][6] . Carotid intima-media thickness (cIMT) is widely used as a marker for atherosclerosis, and several studies have reported that a higher cIMT is related to the incidence of CHD, stroke, and CVD [7][8][9][10][11] . type 1 survey (40,433 participants) was conducted at specific municipal health check-up sites.…”

The Predictive Value of Carotid Ultrasonography With Cardiovascular Risk Factors—A “SPIDER” Promoting Atherosclerosis

“…In the Circulatory Risk Communities Study, heterogeneous plaques correlated positively with increased risk of total stroke, ischemic stroke, lacunar infarction, coronary artery disease, and total cardiovascular disease. In addition, patients with markedly irregular or ulcerated plaques had a significantly higher risk for coronary artery disease and total cardiovascular disease but not stroke ( 28 ). Recording plaque location, thickness, area, and number is recommended for a more precise description of carotid plaques ( 31 ).…”