A cohort study of longitudinal change trajectories of carotid artery maximum plaque area on the new-onset cardiovascular diseases
Objective To explore the value of the longitudinal change trajectories of the carotid artery maximum plaque area in predicting new-onset cardiovascular diseases(CVD),and provide the scientific basis for the prevention and treatment of CVD.Methods People(≥65 years old)who participated in continuing 5 physical examinations in 2014,2015,2016,2017 and 2018 in Hangzhou Wuyunshan Hospital,were selected as the subjects.The retrospective analysis was performed for the carotid artery maximum plaque area values in continuing 5 physical examinations from 2014 to 2018.The physical examination in 2018 served as the starting point of follow-up,and developing CVD served as the end point of follow-up,excluding 30 cases who could not comply with the follow-up plan and voluntarily withdrew from the study,and 411 cases were finally included in the study.According to the longitudinal change trajectories of carotid artery maximum plaque area,198 cases served as the low level-increasing group,174 cases served as the medium level-increasing group,20 cases served as the high level-increasing group and 19 cases served as decreasing after increasing group.The baseline and follow-up investigations included the history collection,physical examination,laboratory test,and carotid ultrasound.The trajectory model of the maximum carotid plaque area was established using the Latent class mixed model(LCMM),the used software was R 4.2.1.The single variance analysis,Kruskal-Wallis rank sum test,x2 test,x2 trend test and Cox proportional risk regression model were used to analyze the data,the used software was SPSS 26.0.Results The duration of followed up was(3.57±1.03)years,new CVD patients were 70 cases,the incidence density was 4.78/100 person-years.The trend of CVD incidence density elevated with the increase of the longitudinal trajectory of the carotid artery maximum plaque area(x2trend=22.221,P＜0.01),the CVD incidence density in the high level-increasing group was the highest(20.37/100 person-years).Cox proportional risk regression analysis model showed that after adjusting the confounding factors,the risk of CVD in high level-increasing groups was 8.787 times(95％CI:3.684-20.955)higher than that in the low level-increasing group(P＜0.05).Conclusion There are different longitudinal trajectories of the carotid artery maximum plaque area in the elderly(≥65 years old),and predictive value of different longitudinal trajectories for new CVD varies.The risk of developing CVD in in elderly with high level of the longitudinal trajectory of carotid artery maximum plaque area is high.
Carotid artery maximum plaque areaLongitudinal trajectoryCardiovascular diseasesCohort study
NETL
NSTL
万方数据
