Table 3. Summary of findings from cohort studies on the association between carotid stiffness-related indices and incident cardiovascular events and/or mortality.
|
Author Study Year Reference |
Design Region |
・No. of subjects ・% of male ・Subjects ・mean age |
Mean follow-up period |
Stiffness-related index of carotidartery |
HR [95% confidence interval] of each index for CVD events or mortality |
|---|---|---|---|---|---|
| Stork S, et al. 2004 105) | Single center Netherlands |
・367 ・100% ・elderly men ・78 years |
48 months |
・β index ・YEM ・No. of plaques |
All-cause mortality: HR per 1-unit ・β index 1.01 [0.99–1.04] a ・YEM 1.26 [0.95–1.66] a ・No. of plaques 1.35 [1.12–1.64] b CVD mortality: HR per 1-unit ・β index 1.05 [1.01–1.08] a ・YEM 1.68 [1.26–2.26] b ・No. of plaques 1.18 [1.04–1.33] b |
|
Dijk J, et al. The SMART study 2005 106) |
Single center Netherlands |
・2,183 ・75% ・Subjects with manifest arterial diseases or CVD risks ・59.7 years |
2.8 years (range, 0.1-6.5 years) |
・β index ・DC ・CC ・Ep ・YEM |
CVD events ・β index 1.03 [1.02–1.05], 1.01 [0.99–1.03] c ・DC 0.94 [0.91–0.97], 0.97 [0.93–1.01] c ・CC 0.55 [0.31–0.95], 0.84 [0.43–1.64] c ・Ep 1.24 [1.13–1.38], 1.07 [0.91–1.25] c ・YEM 1.49 [1.21–1.83], 1.15 [0.84–1.57] c CVD death・β index 1.04 [1.03–1.06], 1.01 [0.98–1.04] c ・DC 0.88 [0.84–0.92], 0.94 [0.88–1.00] c ・CC 0.29 [0.13–0.66], 1.00 [0.39–2.57] c ・Ep 1.37 [1.22–1.53], 1.07 [0.87–1.30] c ・YEM 1.79 [1.44–2.23], 1.29 [0.90–1.86] c |
|
Mattace-Raso F, et al. The Rotterdam study 2006 107) |
Population-based study Netherlands |
・2,835 ・39.2% ・Healthy subjects ・71.7 years |
4.1 years for CAD 3.2 years for stroke |
・DC |
CVD: HR of 1st or 2nd vs 3rd tertile as reference (1.00) ・1st tertile 2.12 [1.27–3.55] d , 1.37 [0.752–2.47] e ・2nd tertile 1.52 [0.91–2.53] d , 1.23 [0.72–2.09] e CAD: HR of 1st or 2nd vs 3rd tertile as reference (1.00) ・1st tertile 1.81 [0.94–3.49] d , 1.32 [0.68–2.54] e ・2nd tertile 1.67 [0.89–3.13] d , 1.12 [0.52–2.39] e Stroke: HR of 1st or 2nd vs 3rd tertile as reference (1.00) ・1st tertile 2.13 [0.96–4.76] d , 1.39 [0.55–3.52] e ・2nd tertile 1.03 [0.44–2.42] d , 0.86 [0.35–2.09] e |
|
Leone N et al. The Three-City Study2008 108) |
Population->based study France |
・3,337 ・39.4% ・The elderly( ＞ 65 years) ・73.2 years |
43.4 months ＊ |
・β index ・Distension (%) ・DC ・CC ・YEM |
CAD: HR of 2nd or 3rd tertile vs 1st tertile as reference (1.00) β index ・2nd tertile 1.03 [0.67–1.58], 0.95 [0.61–1.47] f ・3rd tertiel 1.12 [0.73–1.71], 0.93 [0.59–1.45] f ・Per 1-SD 1.15 [0.98–1.34], 1.06 [0.90–1.25] f HRs for any other indices were statistically non-significant. |
|
Shoji T, et al. 2010 109) |
Single center Japan |
・423 ・61% ・Subjects on hemodialysis ・59.6 years |
70 months |
・β index ・IMT |
CVD mortality: HR per 1-SD β index 1.99 [1.65–2.42], 1.36 [1.08–1.71] g IMT 2.00 [1.73–2.33], 1.37 [1.16–1.62] g |
|
Yang E, et al. The ARIC study 2012 110) |
Population-based study United States |
・10,407 ・63.6% ・Middle-aged individuals (45 to 64 years) ・56.8 years |
13.8 years |
・β index ・CC ・DC ・Ep ・YEM |
CAD: HR per 1-SD ＊＊ ・β index 1.12 [1.06–1.18] h , 0.97 [0.91–1.03] i ・CC 1.12 [1.05–1.19] h , 0.96 [0.90–1.02] i ・DC 1.28 [1.20–1.37] h , 1.01 [0.94–1.09] i ・Ep 1.20 [1.14–1.26] h , 0.96 [0.90–1.02] i ・YEM 1.05 [0.997–1.11] h , 0.96 [0.90–1.03] i Stroke: HR per 1-SD ＊＊ ・β index 1.29 [1.19–1.40] h , 1.14 [1.04–1.25] i ・CC 1.23 [1.09–1.40] h , 1.02 [0.89–1.16] i ・DC 1.58 [1.38–1.81] h , 1.19 [1.02–1.39] i ・Ep 1.38 [1.28–1.48] h , 1.16 [1.06–1.28] i ・YEM 1.25 [1.16–1.35] h , 1.16 [1.05–1.28] i |
* , median of follow-up period; ** , 1-SD decrease for CC and DC, 1-SD increase for β index, Ep, and YEM.
a , adjusted for age; b , adjusted for age and multiple covariates; c , adjusted for age, mean blood pressure, sex, smoking, and the use of antihypertensive drugs; d , adjusted for age and gender, e , adjusted for 11 additional known risk factors including IMT, ankle-arm index, and pulse pressure; f , adjusted for16 covariates including IMT, and carotid plaque; g , adjusted for 13 covariates; h , adjusted for age, gender, study site, and race; i , adjusted for multiple covariates including 12 risk factors and IMT.
Abbreviations: No., number; HR, hazard ratio; CVD, cardiovascular disease; YEM, Young’s elastic modulus; β index, stiffness parameter β ; DC, distensibility coefficient; CC, compliance coefficient; Ep, Peterson’s elastic modulus or pressure-strain modulus; CAD, coronary artery disease; IMT, intima-medial thickness; SD, standard deviation.