Common Carotid End-Diastolic Velocity and Intima-Media Thickness Jointly Predict Ischemic Stroke in Taiwan

Chuang, Shao Yuan; Bai, Chyi Huey; Chen, Jiunn Rong; Yeh, Wen Ting; Chen, Hsin-Jen; Chiu, Hou Chang; Shiu, Ruei Shiang; Pan, Wen Harn

doi:10.1161/strokeaha.110.605477

Cited by 42 publications

(42 citation statements)

References 33 publications

(37 reference statements)

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“…Flow velocity, obtained by Doppler sonography, has been demonstrated to have prognostic value. 6 Low carotid flow enddiastolic velocity (EDV) is associated with an increased risk of stroke 6 and significantly increases the prediction of cardiovascular events. 7 The carotid flow pulsatility, calculated from the difference between peak systolic velocity (PSV) and EDV divided by the mean flow velocity, reflects the transmission of pulsatile energy into the cerebral microcirculation.…”

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confidence: 99%

Blood Pressure, Carotid Flow Pulsatility, and the Risk of Stroke

Chuang

Cheng

Bai

et al. 2016

Stroke

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Background and Purpose-High blood pressure is a major cause of cardiovascular events, and carotid flow pulsatility may be associated with cardiovascular events. However, the combined effect of blood pressure and flow pulsatility on the development of stroke remains unclear. Therefore, we investigated the combined influence of central blood pressure and pulsatility index (PI) on the incidence of stroke. Methods-Baseline data from 2033 adults (≥30 years) without stroke history in the Cardiovascular Disease Risk Factor Two-Township Study were linked to incident stroke. Common carotid flow PI was calculated by peak systolic velocity, end-diastolic velocity, and mean vessel velocity, which were measured in the common carotid artery. Hazard ratios for the risk of total stroke resulting from high central systolic blood pressure (CSBP) and high PI were calculated with Cox proportional hazard models. Results-Over a median follow-up of 9.81 years, 132 people incurred stroke events. The incidence rates of stroke were 1.3, 6.4, and 13.2 per 1000 person-years for tertile groups of CSBP (P for trend<0.05) and 4.3, 7.0, and 9.4 per 1000 personyears for tertile groups of PI (P for trend<0.05). Compared with the first tertile of CSBP, hazard ratios were 4.88 (95% confidence interval, 2.29-10.43) for the second tertile and 10.42 (5.05-21.53) for the third tertile. Hazard ratios of PI were 2.18 (1.39-3.42; third tertile) and 1.64 (1.02-2.63; second tertile) compared with the first tertile. The individuals with a high CSBP and high PI had a 13-fold higher stroke risk compared with those with low CSBP and low PI (13.2; 1.75-99.71) after adjusting for age, sex, and traditional cardiovascular risk. Conclusions-CSBP and common carotid PI jointly and independently predicted future stroke. Carotid flow pulsatility may play an important role in the development of stroke.

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confidence: 99%

Blood Pressure, Carotid Flow Pulsatility, and the Risk of Stroke

Chuang

Cheng

Bai

et al. 2016

Stroke

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“…Meanwhile, recent cross-sectional studies have reported that CIMT had a significant negative association with carotid artery flow velocity [11,12], and that CIMT was more highly associated with EDV than PSV in a large population [12]. However, another cross-sectional study reported that PSV is more associated with a cardiovascular event than EDV in hypertensive patients [15].…”

Section: Discussionmentioning

confidence: 99%

“…3) CVD-related biochemical markers such as serum lipids, glucose, and C-reactive protein were not examined in this study. Demonstration of the association between CVD-associated biochemical markers and CIMT requires a crosssectional study of a larger population [11,39].…”

Section: Limitation Of the Studymentioning

confidence: 99%

“…Moreover, two follow-up studies reported that carotid artery peak systolic flow velocity (PSV) and end diastolic flow velocity (EDV) are negatively associated with CIMT in Taiwanese adults [11,12]. Another cross-sectional study reported that CIMT was independently associated with muscle strength (MS) evaluated by hand grip strength in children [13].…”

Section: Introductionmentioning

confidence: 99%

“…PSV and EDV are reported risk factors for development of CVD and ischemic stroke [11,12,14,15]. MS evaluated by hand grip strength is also reportedly an important predictor of risk for CVD, coronary heart disease, and stroke [16][17][18][19].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Muscle strength and carotid artery flow velocity is associated with increased risk of atherosclerosis in adults

jinkee

Park

2017

Cardiol J

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Increased risk of stroke among patients with ankylosing spondylitis: a population-based matched-cohort study

et al. 2013

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Ankylosing spondylitis (AS) is a chronic inflammatory rheumatic disease. Although two prior studies detected increased prevalence ratios of cerebrovascular disease among AS patients, the results of the two studies investigating AS and stroke are in conflict. Therefore, the present cohort study set out to estimate the risk of subsequent stroke in AS patients compared with matched controls using a population-based dataset in Taiwan. This investigation analyzed administrative claims data sourced from the Taiwan National Health Insurance Database. Our study consisted of a study cohort comprising 1,479 AS patients and a comparison cohort of 5,916 subjects without AS. Cox proportional hazards regressions were performed to estimate the risk of subsequent stroke during the follow-up period. We also conducted additional analyses investigating the risk of subsequent stroke by gender and pharmaceutical prescription. After adjusting for chronic lower respiratory diseases, type 2 diabetes mellitus, hypertension, hyperlipidemia, renal disease, coronary heart disease, atrial fibrillation, income, and urbanization, compared with comparison patients, the hazard ratio for subsequent stroke among patients with AS was 2.3 (95 % CI 1.9-2.8). We also stratified our results by both gender and pharmaceutical prescription, but did not find a statistically significant difference for the risk of subsequent stroke either between men and women, or between AS patients taking various pharmaceutical regimens and the overall AS population. This is the first study to report an increased hazard ratio for subsequent stroke among AS patients when compared with matched comparison patients without AS.

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Common Carotid End-Diastolic Velocity and Intima-Media Thickness Jointly Predict Ischemic Stroke in Taiwan

Cited by 42 publications

References 33 publications

Blood Pressure, Carotid Flow Pulsatility, and the Risk of Stroke

Blood Pressure, Carotid Flow Pulsatility, and the Risk of Stroke

Muscle strength and carotid artery flow velocity is associated with increased risk of atherosclerosis in adults

Increased risk of stroke among patients with ankylosing spondylitis: a population-based matched-cohort study

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