Clinical Utility of Carotid Ultrasonography in the Prediction of Cardiovascular Events in Patients with Diabetes: A Combined Analysis of Data Obtained in Five Longitudinal Studies

• Katakami Naoto

  Department of Metabolic Medicine, Osaka University Graduate School of Medicine Department of Metabolism and Atherosclerosis, Osaka University Graduate School of Medicine

• Mita Tomoya

  Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine Center for Molecular Diabetology, Juntendo University Graduate School of Medicine

• Gosho Masahiko

  Department of Clinical Trial and Clinical Epidemiology, Faculty of Medicine, University of Tsukuba

• Takahara Mitsuyoshi

  Department of Metabolic Medicine, Osaka University Graduate School of Medicine Department of Diabetes Care Medicine, Osaka University Graduate School of Medicine

• Irie Yoko

  Osaka Police Hospital

• Yasuda Tetsuyuki

  Osaka Police Hospital

• Matsuoka Taka-aki

  Department of Metabolic Medicine, Osaka University Graduate School of Medicine

• Osonoi Takeshi

  Nakakinen Clinic

• Watada Hirotaka

  Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine Center for Molecular Diabetology, Juntendo University Graduate School of Medicine Center for Therapeutic Innovations in Diabetes, Juntendo University Graduate School of Medicine

• Shimomura Iichiro

  Department of Metabolic Medicine, Osaka University Graduate School of Medicine

抄録

Aim: It remains unclear whether measures used in carotid ultrasonography such as the intima–media thickness (IMT) and ultrasonic tissue characterization of the carotid using the gray-scale median (GSM) can add prognostic information beyond the conventional cardiovascular risk markers in patients with diabetes. Methods: This study employed a combined analysis of data obtained in five longitudinal studies including a total of 3263 patients with diabetes but without apparent cardiovascular disease (CVD) at baseline. The associations between carotid ultrasonography measures and the first occurrence of CVD (488 cases), which were defined as cardiovascular death, coronary artery diseases, stroke, or peripheral artery disease, were analyzed. Results: Common carotid artery (CCA)-mean-IMT, CCA-max-IMT, Max-IMT, plaque-GSM, and the presence of low-GSM echolucent plaques at baseline were prognostic factors for CVD even after adjustment for conventional risk factors. Time-dependent receiver-operating-characteristic (ROC) curve analysis indicated that the use of CCA-mean-IMT, CCA-max-IMT, and Max-IMT in addition to the conventional risk factors improved significantly the prediction of occurrence of CVD. Increments in the CCA-mean-IMT (hazard ratio [HR] 2.37 for every 0.1-mm/year increment [95% confidence interval [CI]: 1.63–3.47], p＜0.001), Max-IMT (HR 1.51 for every 0.1-mm/year increment [95% CI: 1.07–2.14], p=0.020), and Mean-GSM (HR 0.22 for every 10-U/year increment [95% CI: 0.06–0.76], p=0.016) during the observation period were also prognostic factors for CVD even after adjusting for the baseline value of the respective measure. Conclusions: Addition of carotid ultrasonography measures to conventional risk factors significantly improved the stratification of patients by cardiovascular risk. Changes over time in carotid ultrasonography measures may be used as therapeutic outcome measures.

収録刊行物

• Ｊｏｕｒｎａｌ　ｏｆ　Ａｔｈｅｒｏｓｃｌｅｒｏｓｉｓ　ａｎｄ　Ｔｈｒｏｍｂｏｓｉｓ

  Ｊｏｕｒｎａｌ　ｏｆ　Ａｔｈｅｒｏｓｃｌｅｒｏｓｉｓ　ａｎｄ　Ｔｈｒｏｍｂｏｓｉｓ 25 (10), 1053-1066, 2018-10-01

  一般社団法人 日本動脈硬化学会

キーワード

• IMT
• Carotid plaque
• Tissue characterization
• Cardiovascular diseases
• Diabetes mellitus

詳細情報

• CRID: 1390845713026972160
• NII論文ID: 130007493839
• NII書誌ID: AA11018976
• DOI: 10.5551/jat.43141
• ISSN: 18803873
• ISSN: 13403478
• HANDLE: 2241/00154053
• PubMed: 29445076
• Web Site: https://tsukuba.repo.nii.ac.jp/records/48565
• Web Site: https://www.jstage.jst.go.jp/article/jat/25/10/25_43141/_pdf
• 本文言語コード: en
• データソース種別:
  • JaLC
  • IRDB
  • Crossref
  • PubMed
  • CiNii Articles
  • KAKEN
• 抄録ライセンスフラグ: 使用不可