Published online before print November 4, 2004, doi: 10.1161/01.STR.0000147723.52033.9e
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
(Stroke. 2004;35:2788.)
© 2004 American Heart Association, Inc.
Original Contributions |
Carotid Intima-Media Thickness and Plaque Characteristics as a Risk Factor for Stroke in Japanese Elderly Men
From the Osaka Medical Center for Health Science and Promotion (A.K., H. Imano, T. Ohira, T. Okada, S.S., M.K., T.S.), Japan; and the Department of Public Health Medicine (H. Iso, T.T., K.Y.), Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan.
Correspondence to Dr Akihiko Kitamura, Osaka Medical Center for Health Science and Promotion, 1-3-2 Nakamichi, Higashinari-ku, Osaka 537-0025, Japan. E-mail xkita{at}kenkoukagaku.jp
Background and Purpose— Few cohort studies have examined the association of carotid intima-media thickness (IMT) and plaque characteristics with the risk of stroke in apparently healthy persons. We examined the relationship of carotid IMT and the surface, morphology, and calcification of carotid plaques with the incidence of stroke among Japanese men.
Methods— Carotid IMT and plaque were evaluated bilaterally with ultrasonography in 1289 men aged 60 to 74 years without a previous stroke or coronary heart disease. In this cohort, the subsequent incidence of stroke was investigated.
Results— During the 4.5-year follow-up, 34 strokes occurred. The multivariate-adjusted relative risk (95% CI) for the highest versus lowest quartiles of maximum IMT of the common carotid artery (CCA; 
1.07 versus 
0.77 mm) was 3.0 (1.1 to 8.3) for stroke. The combination of CCA and internal carotid artery (ICA) wall thickness was a better predictor of the risk of stroke than was CCA wall thickness alone. Men with a plaque, defined as a focal wall thickness of 1.5 mm, in the ICA had a 3-fold higher risk of stroke than those without a plaque, and the plaque surface irregularity further increased the stroke risk. A significant excess risk of stroke was confined to men with an uncalcified plaque.
Conclusions— Increased IMT of the CCA and an uncalcified plaque in the ICA, as assessed by ultrasonography, are risk factors for stroke in elderly Japanese men.
Key Words: atherosclerosis • carotid artery • epidemiology • risk factors • stroke
This article has been cited by other articles:
 |
|
 |
|
  M. Helfand, D. I. Buckley, M. Freeman, R. Fu, K. Rogers, C. Fleming, and L. L. Humphrey Emerging Risk Factors for Coronary Heart Disease: A Summary of Systematic Reviews Conducted for the U.S. Preventive Services Task Force Ann Intern Med, October 6, 2009; 151(7): 496 - 507. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Griffin, A. Nicolaides, T. Tyllis, N. Georgiou, R. M Martin, D. Bond, A. Panayiotou, C. Tziakouri, C. J Dore, and C. Fessas Carotid and femoral arterial wall changes and the prevalence of clinical cardiovascular disease Vascular Medicine, August 1, 2009; 14(3): 227 - 232. [Abstract] [PDF]
|
|
|
|
 |
|
 P. Kaul and P. S. Douglas Atherosclerosis Imaging: Prognostically Useful or Merely More of What We Know? Circ Cardiovasc Imaging, March 1, 2009; 2(2): 150 - 160. [Full Text] [PDF]
|
|
|
|
 |
|
 P. Prati, A. Tosetto, D. Vanuzzo, G. Bader, M. Casaroli, L. Canciani, S. Castellani, and P.-J. Touboul Carotid Intima Media Thickness and Plaques Can Predict the Occurrence of Ischemic Cerebrovascular Events Stroke, September 1, 2008; 39(9): 2470 - 2476. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. M. Kwee, R. J. van Oostenbrugge, L. Hofstra, G. J. Teule, J.M.A. van Engelshoven, W. H. Mess, and M. E. Kooi Identifying vulnerable carotid plaques by noninvasive imaging Neurology, June 10, 2008; 70(24_Part_2): 2401 - 2409. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. J. Cao, A. M. Arnold, T. A. Manolio, J. F. Polak, B. M. Psaty, C. H. Hirsch, L. H. Kuller, and M. Cushman Association of Carotid Artery Intima-Media Thickness, Plaques, and C-Reactive Protein With Future Cardiovascular Disease and All-Cause Mortality: The Cardiovascular Health Study Circulation, July 3, 2007; 116(1): 32 - 38. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E.J. Lee, H.J. Kim, J.M. Bae, J.C. Kim, H.J. Han, C.S. Park, N.H. Park, M.S. Kim, and J.A. Ryu Relevance of Common Carotid Intima-Media Thickness and Carotid Plaque as Risk Factors for Ischemic Stroke in Patients with Type 2 Diabetes Mellitus AJNR Am. J. Neuroradiol., May 1, 2007; 28(5): 916 - 919. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. L. Bots, D. Baldassarre, A. Simon, E. de Groot, D. H. O'Leary, W. Riley, J. J. Kastelein, and D. E. Grobbee Carotid intima-media thickness and coronary atherosclerosis: weak or strong relations? Eur. Heart J., February 2, 2007; 28(4): 398 - 406. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. W. Lorenz, H. S. Markus, M. L. Bots, M. Rosvall, and M. Sitzer Prediction of Clinical Cardiovascular Events With Carotid Intima-Media Thickness: A Systematic Review and Meta-Analysis Circulation, January 30, 2007; 115(4): 459 - 467. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Prabhakaran, T. Rundek, R. Ramas, M. S.V. Elkind, M. C. Paik, B. Boden-Albala, and R. L. Sacco Carotid Plaque Surface Irregularity Predicts Ischemic Stroke: The Northern Manhattan Study Stroke, November 1, 2006; 37(11): 2696 - 2701. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. M. Dijk, Y. van der Graaf, M. L. Bots, D. E. Grobbee, A. Algra, and on behalf of the SMART study group Carotid intima-media thickness and the risk of new vascular events in patients with manifest atherosclerotic disease: the SMART study Eur. Heart J., August 2, 2006; 27(16): 1971 - 1978. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N.F. Fanning, T.D. Walters, A.J. Fox, and S.P. Symons Association between Calcification of the Cervical Carotid Artery Bifurcation and White Matter Ischemia. AJNR Am. J. Neuroradiol., February 1, 2006; 27(2): 378 - 383. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. W. Lorenz, S. von Kegler, H. Steinmetz, H. S. Markus, and M. Sitzer Carotid Intima-Media Thickening Indicates a Higher Vascular Risk Across a Wide Age Range: Prospective Data From the Carotid Atherosclerosis Progression Study (CAPS) Stroke, January 1, 2006; 37(1): 87 - 92. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. F. Drager, L. A. Bortolotto, M. C. Lorenzi, A. C. Figueiredo, E. M. Krieger, and G. Lorenzi-Filho Early Signs of Atherosclerosis in Obstructive Sleep Apnea Am. J. Respir. Crit. Care Med., September 1, 2005; 172(5): 613 - 618. [Abstract] [Full Text] [PDF]
|
|