[Association between carotid artery plaques and all-cause mortality and cardiovascular events].

Objective: To observe the association of carotid artery plaque with all-cause mortality and cardiovascular events. Methods: A total of 7 017 participants who completed the carotid sonography examination between 2010 and 2011 were selected from the stroke and the elderly prospective cohort Kailuan study. The participants of stroke cohort received health examination between 2006 and 2007, and participants of elderly cohort received health examination between 2010 and 2011. All participants were divided into plaque group (3 285 cases) and without plaque group (3 732 cases) according to with or without carotid artery plaque.The all-cause mortality and cardiovascular events were compared between the 2 groups. Multivariate Cox regression analysis was used to identify the association of carotid artery plaque with all-cause mortality and cardiovascular events. Results: (1) There were 4 297 male (61.2%) and 2 720 female (38.8%) in this cohort and participants were (58.1±11.8) years old. Age, systolic blood pressure, diastolic blood pressure, fasting plasma glucose, total cholesterol, low-density lipoprotein cholesterol, rates of male, smoking, drinking, history of hypertension and diabetes mellitus were higher in the plaque group than in the without plaque group, and high density lipoprotein cholesterol was lower in the plaque group than in the without plaque group (all P<0.01) at baseline. (2) During a follow-up period of (4.92±0.59) years, the incidence rates of all-cause mortality in the plaque group and without plaque group were 5.5% (180/3 285) and 1.5% (57/3 732) ,respectively (P<0.01) .The incidence rates of cardiovascular events in the plaque group and without plaque group were 3.8% (124/3 285) and 1.4% (52/3 732) , respectively (P<0.01) . (3) Multivariate Cox regression analysis showed that carotid plaque was an independent risk factor of all-cause mortality (HR=1.667, 95%CI 1.160-2.395, P<0.01) and cardiovascular events (HR=1.942, 95%CI 1.312-2.876, P<0.01) after adjusting for age, sex, systolic blood pressure, diastolic blood pressure, fasting plasma glucose, body mass index, total cholesterol,low density lipoprotein cholesterol, high density lipoprotein cholesterol, smoking, drinking, history of hypertension and diabetes mellitus, and use of lipid-regulating drugs. Conclusion: Carotid plaque is an independent risk factor of all-cause mortality and cardiovascular events. Clinical Trial Registration Chinese Clinical Trials Registry, ChiCTR-TNC-11001489.目的： 探讨颈动脉斑块与全因死亡及心脑血管事件的关系。 方法： 纳入2010至2011年完成颈动脉超声检查的开滦研究（前瞻性队列研究）卒中队列和老年队列研究对象7 017例。其中，卒中队列的研究对象2006至2007年参加开滦集团健康体检，老年队列的研究对象2010至2011年参加开滦集团健康体检。按照颈动脉有无斑块，将研究对象分为斑块组（3 285例）和无斑块组（3 732例）。比较两组的全因死亡及心脑血管事件发生率，采用Cox比例风险回归模型分析颈动脉斑块与全因死亡及心脑血管事件的关系。 结果： （1）研究对象平均年龄为（58.1±11.8）岁。男性4 297例（61.2%），女性2 720例（38.8%）。斑块组基线年龄、收缩压、舒张压、空腹血糖、总胆固醇、低密度脂蛋白胆固醇及男性、吸烟、饮酒、高血压和糖尿病病史比率均高于无斑块组，而高密度脂蛋白胆固醇低于无斑块组（P均<0.01）。（2）随访（4.92±0.59）年，斑块组和无斑块组全因死亡发生率分别为5.5%（180/3 285）和1.5%（57/3 732），差异有统计学意义（P<0.01）；斑块组和无斑块组心脑血管事件发生率分别为3.8%（124/3 285）和1.4%（52/3 732），差异有统计学意义（P<0.01）。（3）Cox比例风险回归模型显示,在校正年龄、性别、收缩压、舒张压、空腹血糖、体重指数、总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、吸烟、饮酒、高血压病史、糖尿病史和服用调脂药物后，颈动脉斑块是全因死亡（HR=1.667，95%CI 1.160~2.395，P<0.01）和心脑血管事件（HR=1.942，95%CI 1.312~2.876，P<0.01）的独立危险因素。 结论： 颈动脉斑块是全因死亡及心脑血管事件的独立危险因素。临床试验注册中国临床试验注册中心，注册号为ChiCTR-TNC-11001489。.