Carotid Atherosclerosis Progression and Risk of Cardiovascular Events in a Community in Taiwan

Abstract

The authors investigated the association between progression of carotid atherosclerosis and incidence of cardiovascular disease in a community cohort in Taiwan Ultrasound measures of carotid intima-media thickness (IMT) and plaque are non-invasive methods for measuring atherosclerotic burden and strongly associated with vascular risk factors 1 and incidence of cardiovascular events 2,3 . Carotid IMT and plaque have been used as a surrogate of cardiovascular diseases in observational studies and clinical trials, in which change of these carotid ultrasound measurements over time were the outcome measures for assessing the effects of exposures or interventions 4,5 . However, existing data regarding the association between progression of carotid IMT and risk of cardiovascular events remains inconclusive [6][7][8] . A recent meta-analysis collating data from cohort studies of general populations revealed no relationship between progression rate of common carotid artery intima-media thickness (CCA IMT) and risk of cardiovascular events 6 . Although the analysis was on a large scale, the populations included were mainly from US and Europe; there was only 1 stroke event from Chinese participants. Furthermore, evidence showed that single measurement of carotid plaque is a stronger predictor of risk of cardiovascular events than is IMT 9,10 ; the risk associated with plaque progression, however, has not been well documented yet in general populations.Evidence has shown ethnic differences in cardiovascular risk factors and atherosclerosis process 11,12 . Whether the observations derived mainly from studies of Caucasians origin holds true in Asian populations is unclear. Within a community cohort in Taiwan, we investigated whether change of CCA IMT and formation of new carotid plaque is associated with risk of developing cardiovascular diseases.

Soluble CD40 receptor is a biomarker of the burden of carotid artery atherosclerosis in subjects at high cardiovascular risk

“…However, this approach manifests a substantial lack of accuracy particularly in a real world setting and in high risk populations, in which the treatment intensity of modifiable risk factors is proportional to the degree of CVD risk (4) . In the search for complementary diagnostic methods, ultrasound assessment of carotid atherosclerosis has proven a valid predictor of CVD events (5,6) , number of plaques and total plaque area being closely associated with coronary and systemic atherosclerosis (7)(8)(9)(10) .…”

High sdLDL Cholesterol can be Used to Reclassify Individuals with Low Cardiovascular Risk for Early Intervention: Findings from the Chinese Multi-Provincial Cohort Study

“…Several observational studies have demonstrated that the high small dense LDL cholesterol (sdLDLC) level is strongly associated with CVD events [11][12][13][14] , even more so than the LDLC level 11,12) . Subclinical atherosclerosis underlies most cardiovascular events 15,16) , and its early detection can improve risk stratification among asymptomatic individuals 17) . However, it remains unclear whether high levels of sdLDLC can promote the development of carotid atherosclerosis, irrespective of the LDLC level, and whether screening for this biomarker in individuals with differing degrees of cardiovascular risk could identify those with even grea ter cardiovascular risk, and assist in the identification of appropriate targets for therapeutic intervention in such individuals.…”

Residential Exposure to PM2.5 and Ozone and Progression of Subclinical Atherosclerosis Among Women Transitioning Through Menopause: The Study of Women's Health Across the Nation

“…17,18 Plaque is a direct measure of atherosclerosis, and its presence in the carotid arteries may better predict CVD risk compared with CIMT alone. 19 Few studies have considered plaque progression, 20 and have been mainly limited to patients who already had significant atherosclerosis. [21][22][23] The role of air pollution in women's cardiovascular health has drawn more attention in recent years.…”