Comparing Carotid Artery Velocities with Current ASCVD Risk Stratification: A Novel Approach to Simpler Risk Assessment.

IF 3.8 4区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Journal of Epidemiology and Global Health Pub Date : 2024-09-30 DOI:10.1007/s44197-024-00308-3
Yueh-Chien Lu, Po-Ju Chen, Sheng-Nan Lu, Fu-Wen Liang, Hung-Yi Chuang
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Abstract

Purpose: To explore the potential of a novel approach to simplify risk assessment by comparing carotid artery velocities with current atherosclerotic cardiovascular disease (ASCVD) risk stratification method using nonlinear measurements.

Methods: In this prospective study conducted at a medical center in southern Taiwan from January 1, 2020, to December 31, 2021, 1636 participants aged 40-75 years without prior ASCVD events were enrolled. Carotid flow velocity was obtained through duplex ultrasonography. ASCVD risk was categorized into two groups according to the 2022 USPSTF guidelines for primary prevention. We analyzed associations between flow indices and ASCVD risk using logistic regression and generalized additive models (GAMs).

Results: The end diastolic velocity (EDV) of common carotid artery (CCA) and the peak systolic velocity (PSV) of internal carotid artery (ICA) were inversely and nonlinearly associated with cardiovascular event risk. Multivariate logistic regression analysis with ROC curves revealed that the optimal speed for the EDV of CCA was approximately 23.75 cm/s, and the optimal PSV and EDV of ICA were approximately 81.75 cm/s and 26.75 cm/s, respectively. The GAMs showed U-shaped relationships between elevated ASCVD risk and blood flow velocity in the carotid arteries, with inflection points of approximately 82 cm/s in the PSV of ICA and near 25 cm/s in the EDV of CCA. Both methods revealed similar results.

Conclusions: The EDVs and PSVs of the CCA and ICA are associated with the development of cardiovascular events. Optimal velocity ranges were identified; however, further hemodynamic investigations are warranted.

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将颈动脉速度与目前的 ASCVD 风险分层进行比较:简化风险评估的新方法。
目的:通过比较颈动脉速度与目前使用非线性测量的动脉粥样硬化性心血管疾病(ASCVD)风险分层方法,探索简化风险评估的新方法的潜力:这项前瞻性研究于 2020 年 1 月 1 日至 2021 年 12 月 31 日在台湾南部的一家医疗中心进行,共招募了 1636 名年龄在 40-75 岁之间、未发生过 ASCVD 事件的参与者。通过双工超声波检查获得颈动脉血流速度。根据 2022 年 USPSTF 初级预防指南,将 ASCVD 风险分为两组。我们使用逻辑回归和广义相加模型(GAMs)分析了血流指数与 ASCVD 风险之间的关系:结果:颈总动脉(CCA)舒张末期速度(EDV)和颈内动脉(ICA)收缩峰值速度(PSV)与心血管事件风险呈非线性反比关系。带有 ROC 曲线的多变量逻辑回归分析显示,CCA EDV 的最佳速度约为 23.75 厘米/秒,ICA 的最佳 PSV 和 EDV 分别约为 81.75 厘米/秒和 26.75 厘米/秒。GAMs显示ASCVD风险升高与颈动脉血流速度之间存在U形关系,ICA的PSV拐点约为82厘米/秒,CCA的EDV拐点接近25厘米/秒。两种方法得出的结果相似:结论:CCA 和 ICA 的 EDV 和 PSV 与心血管事件的发生有关。结论:CCA 和 ICA 的 EDV 和 PSV 与心血管事件的发生有关,已确定了最佳速度范围,但仍需进一步的血液动力学研究。
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来源期刊
CiteScore
10.70
自引率
1.40%
发文量
57
审稿时长
19 weeks
期刊介绍: The Journal of Epidemiology and Global Health is an esteemed international publication, offering a platform for peer-reviewed articles that drive advancements in global epidemiology and international health. Our mission is to shape global health policy by showcasing cutting-edge scholarship and innovative strategies.
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