Common carotid artery wall thickness and external diameter as predictors of prevalent and incident cardiac events in a large population study

Marsha L. Eigenbrodt, Rishi Sukhija, Kathryn M. Rose, Richard E. Tracy, David J. Couper, Gregory W. Evans, Zoran Bursac, Jawahar L. Mehta

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Abstract

Background. Arterial diameters enlarge in response to wall thickening, plaques, and many atherosclerotic risk factors. We hypothesized that right common carotid artery (RCCA) diameter would be independently associated with cardiac disease and improve risk discrimination. Methods. In a middle-aged, biracial population (baseline n = 11225), we examined associations between 1 standard deviation increments of baseline RCCA diameter with prevalent myocardial infarction (MI) and incident cardiac events (MI or cardiac death) using logistic regression and Cox proportional hazards models, respectively. Areas under the receiver operator characteristic curve (AUC) were used to estimate model discrimination. Results. MI was present in 451 (4%) participants at baseline (1987-89), and incident cardiac events occurred among 646 (6%) others through 1999. Adjusting for IMT, RCCA diameter was associated with prevalent MI (female OR = 2.0, 95%CI = 1.61-2.49; male OR = 1.16, 95% CI = 1.04-1.30) and incident cardiac events (female HR = 1.75, 95% CI = 1.51-2.02; male HR = 1.27, 95% CI = 1.15-1.40). Associations were attenuated but persisted after adjustment for risk factors (not including IMT) (prevalent MI: female OR = 1.73, 95% CI = 1.40-2.14; male OR = 1.14, 95% CI = 1.02-1.28, and incident cardiac events: female HR = 1.26, 95% CI = 1.08-1.48; male HR = 1.19, 95% CI = 1.08-1.32). After additional adjustment for IMT, diameter was associated with incident cardiac events in women (HR = 1.18, 95% CI = 1.00-1.40) and men (HR = 1.17, 95% CI = 1.06-1.29), and with prevalent MI only in women (OR = 1.73; 95% CI = 1.37-2.17). In women, when adjustment was limited, diameter models had larger AUC than other models. Conclusion. RCCA diameter is an important correlate of cardiac events, independent of IMT, but adds little to overall risk discrimination after risk factor adjustment.

Original languageEnglish (US)
Article number11
JournalCardiovascular Ultrasound
Volume5
DOIs
StatePublished - Mar 29 2007

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Common Carotid Artery
Myocardial Infarction
Population
Area Under Curve
Risk Adjustment
Atherosclerotic Plaques
Proportional Hazards Models
Heart Diseases
Logistic Models

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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Common carotid artery wall thickness and external diameter as predictors of prevalent and incident cardiac events in a large population study. / Eigenbrodt, Marsha L.; Sukhija, Rishi; Rose, Kathryn M.; Tracy, Richard E.; Couper, David J.; Evans, Gregory W.; Bursac, Zoran; Mehta, Jawahar L.

In: Cardiovascular Ultrasound, Vol. 5, 11, 29.03.2007.

Research output: Contribution to journalArticle

Eigenbrodt, Marsha L. ; Sukhija, Rishi ; Rose, Kathryn M. ; Tracy, Richard E. ; Couper, David J. ; Evans, Gregory W. ; Bursac, Zoran ; Mehta, Jawahar L. / Common carotid artery wall thickness and external diameter as predictors of prevalent and incident cardiac events in a large population study. In: Cardiovascular Ultrasound. 2007 ; Vol. 5.
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abstract = "Background. Arterial diameters enlarge in response to wall thickening, plaques, and many atherosclerotic risk factors. We hypothesized that right common carotid artery (RCCA) diameter would be independently associated with cardiac disease and improve risk discrimination. Methods. In a middle-aged, biracial population (baseline n = 11225), we examined associations between 1 standard deviation increments of baseline RCCA diameter with prevalent myocardial infarction (MI) and incident cardiac events (MI or cardiac death) using logistic regression and Cox proportional hazards models, respectively. Areas under the receiver operator characteristic curve (AUC) were used to estimate model discrimination. Results. MI was present in 451 (4{\%}) participants at baseline (1987-89), and incident cardiac events occurred among 646 (6{\%}) others through 1999. Adjusting for IMT, RCCA diameter was associated with prevalent MI (female OR = 2.0, 95{\%}CI = 1.61-2.49; male OR = 1.16, 95{\%} CI = 1.04-1.30) and incident cardiac events (female HR = 1.75, 95{\%} CI = 1.51-2.02; male HR = 1.27, 95{\%} CI = 1.15-1.40). Associations were attenuated but persisted after adjustment for risk factors (not including IMT) (prevalent MI: female OR = 1.73, 95{\%} CI = 1.40-2.14; male OR = 1.14, 95{\%} CI = 1.02-1.28, and incident cardiac events: female HR = 1.26, 95{\%} CI = 1.08-1.48; male HR = 1.19, 95{\%} CI = 1.08-1.32). After additional adjustment for IMT, diameter was associated with incident cardiac events in women (HR = 1.18, 95{\%} CI = 1.00-1.40) and men (HR = 1.17, 95{\%} CI = 1.06-1.29), and with prevalent MI only in women (OR = 1.73; 95{\%} CI = 1.37-2.17). In women, when adjustment was limited, diameter models had larger AUC than other models. Conclusion. RCCA diameter is an important correlate of cardiac events, independent of IMT, but adds little to overall risk discrimination after risk factor adjustment.",
author = "Eigenbrodt, {Marsha L.} and Rishi Sukhija and Rose, {Kathryn M.} and Tracy, {Richard E.} and Couper, {David J.} and Evans, {Gregory W.} and Zoran Bursac and Mehta, {Jawahar L.}",
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AU - Eigenbrodt, Marsha L.

AU - Sukhija, Rishi

AU - Rose, Kathryn M.

AU - Tracy, Richard E.

AU - Couper, David J.

AU - Evans, Gregory W.

AU - Bursac, Zoran

AU - Mehta, Jawahar L.

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N2 - Background. Arterial diameters enlarge in response to wall thickening, plaques, and many atherosclerotic risk factors. We hypothesized that right common carotid artery (RCCA) diameter would be independently associated with cardiac disease and improve risk discrimination. Methods. In a middle-aged, biracial population (baseline n = 11225), we examined associations between 1 standard deviation increments of baseline RCCA diameter with prevalent myocardial infarction (MI) and incident cardiac events (MI or cardiac death) using logistic regression and Cox proportional hazards models, respectively. Areas under the receiver operator characteristic curve (AUC) were used to estimate model discrimination. Results. MI was present in 451 (4%) participants at baseline (1987-89), and incident cardiac events occurred among 646 (6%) others through 1999. Adjusting for IMT, RCCA diameter was associated with prevalent MI (female OR = 2.0, 95%CI = 1.61-2.49; male OR = 1.16, 95% CI = 1.04-1.30) and incident cardiac events (female HR = 1.75, 95% CI = 1.51-2.02; male HR = 1.27, 95% CI = 1.15-1.40). Associations were attenuated but persisted after adjustment for risk factors (not including IMT) (prevalent MI: female OR = 1.73, 95% CI = 1.40-2.14; male OR = 1.14, 95% CI = 1.02-1.28, and incident cardiac events: female HR = 1.26, 95% CI = 1.08-1.48; male HR = 1.19, 95% CI = 1.08-1.32). After additional adjustment for IMT, diameter was associated with incident cardiac events in women (HR = 1.18, 95% CI = 1.00-1.40) and men (HR = 1.17, 95% CI = 1.06-1.29), and with prevalent MI only in women (OR = 1.73; 95% CI = 1.37-2.17). In women, when adjustment was limited, diameter models had larger AUC than other models. Conclusion. RCCA diameter is an important correlate of cardiac events, independent of IMT, but adds little to overall risk discrimination after risk factor adjustment.

AB - Background. Arterial diameters enlarge in response to wall thickening, plaques, and many atherosclerotic risk factors. We hypothesized that right common carotid artery (RCCA) diameter would be independently associated with cardiac disease and improve risk discrimination. Methods. In a middle-aged, biracial population (baseline n = 11225), we examined associations between 1 standard deviation increments of baseline RCCA diameter with prevalent myocardial infarction (MI) and incident cardiac events (MI or cardiac death) using logistic regression and Cox proportional hazards models, respectively. Areas under the receiver operator characteristic curve (AUC) were used to estimate model discrimination. Results. MI was present in 451 (4%) participants at baseline (1987-89), and incident cardiac events occurred among 646 (6%) others through 1999. Adjusting for IMT, RCCA diameter was associated with prevalent MI (female OR = 2.0, 95%CI = 1.61-2.49; male OR = 1.16, 95% CI = 1.04-1.30) and incident cardiac events (female HR = 1.75, 95% CI = 1.51-2.02; male HR = 1.27, 95% CI = 1.15-1.40). Associations were attenuated but persisted after adjustment for risk factors (not including IMT) (prevalent MI: female OR = 1.73, 95% CI = 1.40-2.14; male OR = 1.14, 95% CI = 1.02-1.28, and incident cardiac events: female HR = 1.26, 95% CI = 1.08-1.48; male HR = 1.19, 95% CI = 1.08-1.32). After additional adjustment for IMT, diameter was associated with incident cardiac events in women (HR = 1.18, 95% CI = 1.00-1.40) and men (HR = 1.17, 95% CI = 1.06-1.29), and with prevalent MI only in women (OR = 1.73; 95% CI = 1.37-2.17). In women, when adjustment was limited, diameter models had larger AUC than other models. Conclusion. RCCA diameter is an important correlate of cardiac events, independent of IMT, but adds little to overall risk discrimination after risk factor adjustment.

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