title: 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. Data has rarely been reported in Asian populations. Study subjects were 1,398 participants who underwent ultrasound measures of common carotid artery intima-media thickness (IMT) and extracranial carotid artery plaque score at both 1994-1995 and 1999-2000 surveys. Cox proportional hazards model was used to assess the risk of incident cardiovascular disease. During a median follow-up of 13 years (1999-2013), 71 strokes and 68 coronary events occurred. The 5-year individual IMT change was not associated with development of cardiovascular events in unadjusted and adjusted models. Among subjects without plaque in 1994-1995, we observed elevated risk associated with presence of new plaque (plaque score >0 in 1999-2000) in a dose-response manner in unadjusted and age- and sex- adjusted models. The associations attenuated and became statistically non-significant after controlling for cardiovascular risk factors (hazard ratio [95% confidence interval] for plaque score >2 vs. 0: stroke, 1.61 [0.79-3.27], coronary events, 1.13 [0.48-2.69]). This study suggested that carotid plaque formation measured by ultrasound is associated increased risk of developing cardiovascular disease, and cardiovascular risk factors explain the associations to a large extent.
authors.affiliation: Clinical Informatics and Medical Statistics Research Center, Chang Gung University, Tao-Yuan 33302, Taiwan.|Department of Neurology, Chang Gung University College of Medicine, Chang Gung Memorial Hospital, Chiayi branch, Chiayi 61363, Taiwan.
authors.forename: Pei-Chun
authors.initials: PC
authors.lastname: Chen
authors.affiliation: Department of Neurology, National Taiwan University Hospital, Taipei 10002, Taiwan.
authors.forename: Jiann-Shing
authors.initials: JS
authors.lastname: Jeng
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taipei 10002, Taiwan.
authors.forename: Hsiu-Ching
authors.initials: HC
authors.lastname: Hsu
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taipei 10002, Taiwan.|Insitute of Occupational Medicine and Industrial Hygiene, National Taiwan University, Taipei 10055, Taiwan.
authors.forename: Ta-Chen
authors.initials: TC
authors.lastname: Su
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taipei 10002, Taiwan.|Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei 10055, Taiwan.
authors.forename: Kuo-Liong
authors.initials: KL
authors.lastname: Chien
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taipei 10002, Taiwan.
authors.forename: Yuan-Teh
authors.initials: YT
authors.lastname: Lee
mesh_terms: D002318:Cardiovascular Diseases / Q000473:pathology*; D002340:Carotid Artery Diseases / Q000473:pathology*; D059168:Carotid Intima-Media Thickness; D018450:Disease Progression; D023381:Endpoint Determination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000473:pathology; D016016:Proportional Hazards Models; D012307:Risk Factors; D013624:Taiwan