Prediction of Severe Baseline Asymptomatic Carotid Stenosis and Subsequent Risk of Stroke and Cardiovascular Disease

医学 冲程(发动机) 无症状的 内科学 心肌梗塞 入射(几何) 一致性 狭窄 心脏病学 机械工程 光学 物理 工程类
作者
Michiel H.F. Poorthuis,Steven H J Hageman,Aernoud T.L. Fiolet,L. Jaap Kappelle,Michiel L. Bots,Philippe Gabríel Steg,Frank L.J. Visseren,Deepak L. Bhatt,Gert J. de Borst
出处
期刊:Stroke [Lippincott Williams & Wilkins]
卷期号:55 (11): 2632-2640
标识
DOI:10.1161/strokeaha.123.046894
摘要

BACKGROUND: Risk models to identify patients at high risk of asymptomatic carotid artery stenosis (ACAS) can help in selecting patients for screening, but long-term outcomes in these patients are unknown. We assessed the diagnostic and prognostic value of the previously published Prevalence of ACAS (PACAS) risk model to detect ACAS at baseline and to predict subsequent risk of stroke and cardiovascular disease (CVD) during follow-up. METHODS: We validated the discrimination and calibration of the PACAS risk model to detect severe (≥70% narrowing) ACAS with patients from the Reduction of Atherothrombosis for Continued Health registry. We subsequently calculated the incidence rates of stroke and CVD (fatal and nonfatal stroke or myocardial infarction or vascular death) during follow-up in 4 risk groups (low, medium, high, and very high, corresponding to sum scores of ≤9, 10–13, 14–17, and ≥18, respectively). RESULTS: Among 26 384 patients, aged between 45 and 80 years, without prior carotid procedures, 1662 (6.3%) had severe baseline ACAS. During ≈70 000 patient-years of follow-up, 1124 strokes and 2484 CVD events occurred. Discrimination of the PACAS model was 0.67 (95% CI, 0.65–0.68), and calibration showed adequate concordance between predicted and observed risks of severe baseline ACAS after recalibration. Significantly higher incidence rates of stroke ( P trend <0.011) and CVD ( P trend <0.0001) during follow-up were found with increasing PACAS risk groups. Among patients with high PACAS sum score of ≥14 (corresponding to 27.7% of all patients), severe baseline ACAS prevalence was 11.4%. In addition, 56.6% of incident strokes and 64.9% of incident CVD events occurred in this group. CONCLUSIONS: The PACAS risk model can reliably identify patients at high risk of severe baseline ACAS. Incidence rates of stroke and CVD during follow-up were significantly higher in patients with high PACAS sum scores. Selective screening of patients with high PACAS sum scores may help to prevent future stroke or CVD.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
布洛小芬完成签到 ,获得积分20
刚刚
whatever应助shark采纳,获得20
刚刚
默默雪旋完成签到 ,获得积分10
刚刚
牧紫菱完成签到,获得积分10
1秒前
2秒前
3秒前
小王发布了新的文献求助10
3秒前
3秒前
Eric完成签到,获得积分10
4秒前
开朗的山彤完成签到,获得积分10
4秒前
维生素完成签到,获得积分10
4秒前
时林完成签到,获得积分10
4秒前
傻瓜完成签到 ,获得积分10
5秒前
6秒前
大观天下发布了新的文献求助10
8秒前
忽远忽近的她完成签到 ,获得积分10
8秒前
维生素发布了新的文献求助10
9秒前
butterfly发布了新的文献求助10
11秒前
豆豆完成签到 ,获得积分10
12秒前
范先生完成签到,获得积分10
15秒前
2222222完成签到,获得积分10
15秒前
Hello应助bulingbuling采纳,获得10
15秒前
蜡笔小新完成签到,获得积分10
18秒前
希望天下0贩的0应助小王采纳,获得10
18秒前
赘婿应助lh采纳,获得10
19秒前
19秒前
科研通AI2S应助butterfly采纳,获得10
20秒前
大模型应助butterfly采纳,获得10
20秒前
22秒前
做个梦给你完成签到,获得积分10
22秒前
学霸宇大王完成签到 ,获得积分10
22秒前
甜蜜的楷瑞完成签到,获得积分10
23秒前
魏煜佳完成签到,获得积分10
24秒前
Lc完成签到,获得积分10
24秒前
三伏天完成签到,获得积分10
24秒前
清图完成签到,获得积分10
24秒前
英姑应助简单采纳,获得10
24秒前
爱喝牛奶的大兔子完成签到 ,获得积分20
25秒前
26秒前
26秒前
高分求助中
【提示信息,请勿应助】关于scihub 10000
Les Mantodea de Guyane: Insecta, Polyneoptera [The Mantids of French Guiana] 3000
徐淮辽南地区新元古代叠层石及生物地层 3000
The Mother of All Tableaux: Order, Equivalence, and Geometry in the Large-scale Structure of Optimality Theory 3000
Global Eyelash Assessment scale (GEA) 1000
Picture Books with Same-sex Parented Families: Unintentional Censorship 550
Research on Disturbance Rejection Control Algorithm for Aerial Operation Robots 500
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 4038388
求助须知:如何正确求助?哪些是违规求助? 3576106
关于积分的说明 11374447
捐赠科研通 3305798
什么是DOI,文献DOI怎么找? 1819322
邀请新用户注册赠送积分活动 892672
科研通“疑难数据库(出版商)”最低求助积分说明 815029