JACC:粥样硬化斑块内出血提示亚临床健康人卒中和冠心病风险增加!

2021-03-22 Nebula MedSci原创

越来越多的证据表明,是动脉粥样硬化斑块的组成,而不是斑块大小,与缺血性心血管事件有关。

越来越多的证据表明,是动脉粥样硬化斑块的组成,而不是斑块大小,与缺血性血管事件有关。然而,目前关于无症状个体的基于人群的大规模数据仍然有限。

本研究目的是在以人群为基础的环境中调查颈动脉斑块成分与卒中和冠心病(CHD)的相关性。

2007-2012年期间,以人群为基础的Rotterdam研究中有1349人(平均72岁,49.5%女性)没有卒中或CHD病史,颈动脉超声显示亚临床动脉粥样硬化,并接受了颈动脉高分辨率MRI以评估斑块特征。评估了有无特殊斑块成分(斑块内出血[IPH]、富含脂质的坏死核心和钙化)、斑块的大小(最大斑块厚度和狭窄程度超过30%)。

卒中和CHD风险预测

随访至2015年1月1日,卒中和冠心病的中位随访时间分别为5.1年和4.8年,共51人发生了卒中,83人发展成了CHD。存在IPH与卒中和CHD风险相关(完全调整的危险比分别为2.42和1.95),且独立于最大斑块厚度和心血管危险因素。富含脂质的坏死核心和钙化的存在与存在或CHD风险无关。

总之,本研究表明,颈动脉粥样硬化斑块存在斑块内出血是卒中和CHD的独立危险因素。这些发现表明IPH有望成为亚临床动脉粥样硬化健康人斑块易损性的标志物。

原始出处:

Bos Daniel,Arshi Banafsheh,van den Bouwhuijsen Quirijn J A et al. Atherosclerotic Carotid Plaque Composition and Incident Stroke and Coronary Events. J Am Coll Cardiol, 2021, 77: 1426-1435. https://doi.org/10.1016/j.jacc.2021.01.038

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    2021-06-23 hbwxf
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content=是动脉粥样硬化斑块的组成,而不是斑块大小,与缺血性心血管事件有关。, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4gCIdSaEkahCNuUWZv4iaKmqvUKHyKnBiarBM9RStQKBeV5Lh6GYYFiamdV5KlSfbLvmAgZTLtq81XA/0, createdBy=13511650672, createdName=言西早, createdTime=Mon Mar 22 23:00:33 CST 2021, time=2021-03-22, status=1, ipAttribution=)]
  5. 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content=是动脉粥样硬化斑块的组成,而不是斑块大小,与缺血性心血管事件有关。, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4gCIdSaEkahCNuUWZv4iaKmqvUKHyKnBiarBM9RStQKBeV5Lh6GYYFiamdV5KlSfbLvmAgZTLtq81XA/0, createdBy=13511650672, createdName=言西早, createdTime=Mon Mar 22 23:00:33 CST 2021, time=2021-03-22, status=1, ipAttribution=)]
  6. 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content=是动脉粥样硬化斑块的组成,而不是斑块大小,与缺血性心血管事件有关。, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4gCIdSaEkahCNuUWZv4iaKmqvUKHyKnBiarBM9RStQKBeV5Lh6GYYFiamdV5KlSfbLvmAgZTLtq81XA/0, createdBy=13511650672, createdName=言西早, createdTime=Mon Mar 22 23:00:33 CST 2021, time=2021-03-22, status=1, ipAttribution=)]
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GetPortalCommentsPageByObjectIdResponse(id=1026801, encodeId=88921026801d3, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Tue Mar 23 01:41:15 CST 2021, time=2021-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1050259, encodeId=c8631050259f5, content=大家一般关心疾病,但是亚临床更重要,这是疾病防控方向的前移,各类疾病都是这样。如亚临床甲减,亚临床心肌损伤,亚临床心衰等, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=jingjing, createdTime=Tue Mar 23 01:41:15 CST 2021, time=2021-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=950228, encodeId=49c795022877, content=是动脉粥样硬化斑块的组成,而不是斑块大小,与缺血性心血管事件有关。, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4gCIdSaEkahCNuUWZv4iaKmqvUKHyKnBiarBM9RStQKBeV5Lh6GYYFiamdV5KlSfbLvmAgZTLtq81XA/0, createdBy=13511650672, createdName=言西早, createdTime=Mon Mar 22 23:00:33 CST 2021, time=2021-03-22, status=1, ipAttribution=)]
  8. 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createdName=lishizhe, createdTime=Sun Nov 28 09:41:15 CST 2021, time=2021-11-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1854900, encodeId=0c281854900ab, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Wed Jun 23 03:41:15 CST 2021, time=2021-06-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1771028, encodeId=a7c51e7102853, content=<a href='/topic/show?id=5572308336a' target=_blank style='color:#2F92EE;'>#冠心病风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30833, 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content=是动脉粥样硬化斑块的组成,而不是斑块大小,与缺血性心血管事件有关。, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4gCIdSaEkahCNuUWZv4iaKmqvUKHyKnBiarBM9RStQKBeV5Lh6GYYFiamdV5KlSfbLvmAgZTLtq81XA/0, createdBy=13511650672, createdName=言西早, createdTime=Mon Mar 22 23:00:33 CST 2021, time=2021-03-22, status=1, ipAttribution=)]
    2021-03-23 健健

    卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!

    0

  9. 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channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57923, encryptionId=a91c5e92328, topicName=斑块)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/101296147/4E6244DB7C1860858424437821E08291/100, createdBy=a6a52500039, createdName=ms3994565386320060, createdTime=Wed Mar 24 13:41:15 CST 2021, time=2021-03-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1568774, encodeId=68f91568e740d, content=<a href='/topic/show?id=eaf85e9272a' target=_blank style='color:#2F92EE;'>#斑块内出血#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57927, encryptionId=eaf85e9272a, topicName=斑块内出血)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=aea015440356, createdName=wleon8900, createdTime=Wed Mar 24 13:41:15 CST 2021, time=2021-03-24, status=1, ipAttribution=), 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content=是动脉粥样硬化斑块的组成,而不是斑块大小,与缺血性心血管事件有关。, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4gCIdSaEkahCNuUWZv4iaKmqvUKHyKnBiarBM9RStQKBeV5Lh6GYYFiamdV5KlSfbLvmAgZTLtq81XA/0, createdBy=13511650672, createdName=言西早, createdTime=Mon Mar 22 23:00:33 CST 2021, time=2021-03-22, status=1, ipAttribution=)]
    2021-03-23 jingjing

    大家一般关心疾病,但是亚临床更重要,这是疾病防控方向的前移,各类疾病都是这样。如亚临床甲减,亚临床心肌损伤,亚临床心衰等

    0

  10. 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GetPortalCommentsPageByObjectIdResponse(id=1026801, encodeId=88921026801d3, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Tue Mar 23 01:41:15 CST 2021, time=2021-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1050259, encodeId=c8631050259f5, content=大家一般关心疾病,但是亚临床更重要,这是疾病防控方向的前移,各类疾病都是这样。如亚临床甲减,亚临床心肌损伤,亚临床心衰等, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=jingjing, createdTime=Tue Mar 23 01:41:15 CST 2021, time=2021-03-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=950228, encodeId=49c795022877, content=是动脉粥样硬化斑块的组成,而不是斑块大小,与缺血性心血管事件有关。, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4gCIdSaEkahCNuUWZv4iaKmqvUKHyKnBiarBM9RStQKBeV5Lh6GYYFiamdV5KlSfbLvmAgZTLtq81XA/0, createdBy=13511650672, createdName=言西早, createdTime=Mon Mar 22 23:00:33 CST 2021, time=2021-03-22, status=1, ipAttribution=)]
    2021-03-22 言西早

    是动脉粥样硬化斑块的组成,而不是斑块大小,与缺血性心血管事件有关。

    0

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