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Carotid Plaque Score and Risk of Cardiovascular Mortality in the Oldest Old: Results from the TOOTH Study

Aim: Accumulating evidence suggests that predictability of traditional cardiovascular risk factors declines with advancing age. We investigated whether carotid plaque scores (CPSs) were associated with cardiovascular disease (CVD) death in the oldest old, and whether asymmetrical dimethylarginine (A...

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Autores principales: Hirata, Takumi, Arai, Yasumichi, Takayama, Michiyo, Abe, Yukiko, Ohkuma, Kiyoshi, Takebayashi, Toru
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Japan Atherosclerosis Society 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5770224/
https://www.ncbi.nlm.nih.gov/pubmed/28179606
http://dx.doi.org/10.5551/jat.37911
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author Hirata, Takumi
Arai, Yasumichi
Takayama, Michiyo
Abe, Yukiko
Ohkuma, Kiyoshi
Takebayashi, Toru
author_facet Hirata, Takumi
Arai, Yasumichi
Takayama, Michiyo
Abe, Yukiko
Ohkuma, Kiyoshi
Takebayashi, Toru
author_sort Hirata, Takumi
collection PubMed
description Aim: Accumulating evidence suggests that predictability of traditional cardiovascular risk factors declines with advancing age. We investigated whether carotid plaque scores (CPSs) were associated with cardiovascular disease (CVD) death in the oldest old, and whether asymmetrical dimethylarginine (ADMA), a marker of endothelial dysfunction, moderated the association between the CPS and CVD death. Methods: We conducted a prospective cohort study of Japanese subjects aged ≥ 85 years without CVD at baseline. We followed this cohort for 6 years to investigate the association of CPS with CVD death via multivariable Cox proportional hazard analysis. We divided participants into three groups according to CPS (no, 0 points; low, 1.2–4.9 points; high, ≥5.0 points). The predictive value of CPS for estimating CVD death risk over CVD risk factors, including ADMA, was examined using C-statistics. Results: We analyzed 347 participants (151 men, 196 women; mean age, 87.6 years), of which 135 (38.9%) had no carotid plaque at baseline, and 48 (13.8%) had high CPS. Of the total, 29 (8.4%) participants experienced CVD-related death during the study period. Multivariable analysis revealed a significant association of high CPS with CVD-related mortality relative to no CPS (hazard ratio, 3.90; 95% confidence interval: 1.47–10.39). ADMA was not associated with CVD death, but the significant association between CPS and CVD death was observed only in lower ADMA level. The addition of CPS to other risk factors improved the predictability of CVD death (p = 0.032). Conclusions: High CPS correlated significantly with a higher CVD death risk in the oldest old with low cardiovascular risk. Ultrasound carotid plaque evaluation might facilitate risk evaluations of CVD death in the very old.
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spelling pubmed-57702242018-01-19 Carotid Plaque Score and Risk of Cardiovascular Mortality in the Oldest Old: Results from the TOOTH Study Hirata, Takumi Arai, Yasumichi Takayama, Michiyo Abe, Yukiko Ohkuma, Kiyoshi Takebayashi, Toru J Atheroscler Thromb Original Article Aim: Accumulating evidence suggests that predictability of traditional cardiovascular risk factors declines with advancing age. We investigated whether carotid plaque scores (CPSs) were associated with cardiovascular disease (CVD) death in the oldest old, and whether asymmetrical dimethylarginine (ADMA), a marker of endothelial dysfunction, moderated the association between the CPS and CVD death. Methods: We conducted a prospective cohort study of Japanese subjects aged ≥ 85 years without CVD at baseline. We followed this cohort for 6 years to investigate the association of CPS with CVD death via multivariable Cox proportional hazard analysis. We divided participants into three groups according to CPS (no, 0 points; low, 1.2–4.9 points; high, ≥5.0 points). The predictive value of CPS for estimating CVD death risk over CVD risk factors, including ADMA, was examined using C-statistics. Results: We analyzed 347 participants (151 men, 196 women; mean age, 87.6 years), of which 135 (38.9%) had no carotid plaque at baseline, and 48 (13.8%) had high CPS. Of the total, 29 (8.4%) participants experienced CVD-related death during the study period. Multivariable analysis revealed a significant association of high CPS with CVD-related mortality relative to no CPS (hazard ratio, 3.90; 95% confidence interval: 1.47–10.39). ADMA was not associated with CVD death, but the significant association between CPS and CVD death was observed only in lower ADMA level. The addition of CPS to other risk factors improved the predictability of CVD death (p = 0.032). Conclusions: High CPS correlated significantly with a higher CVD death risk in the oldest old with low cardiovascular risk. Ultrasound carotid plaque evaluation might facilitate risk evaluations of CVD death in the very old. Japan Atherosclerosis Society 2018-01-01 /pmc/articles/PMC5770224/ /pubmed/28179606 http://dx.doi.org/10.5551/jat.37911 Text en 2018 Japan Atherosclerosis Society This article is distributed under the terms of the latest version of CC BY-NC-SA defined by the Creative Commons Attribution License.http://creativecommons.org/licenses/by-nc-sa/3.0/
spellingShingle Original Article
Hirata, Takumi
Arai, Yasumichi
Takayama, Michiyo
Abe, Yukiko
Ohkuma, Kiyoshi
Takebayashi, Toru
Carotid Plaque Score and Risk of Cardiovascular Mortality in the Oldest Old: Results from the TOOTH Study
title Carotid Plaque Score and Risk of Cardiovascular Mortality in the Oldest Old: Results from the TOOTH Study
title_full Carotid Plaque Score and Risk of Cardiovascular Mortality in the Oldest Old: Results from the TOOTH Study
title_fullStr Carotid Plaque Score and Risk of Cardiovascular Mortality in the Oldest Old: Results from the TOOTH Study
title_full_unstemmed Carotid Plaque Score and Risk of Cardiovascular Mortality in the Oldest Old: Results from the TOOTH Study
title_short Carotid Plaque Score and Risk of Cardiovascular Mortality in the Oldest Old: Results from the TOOTH Study
title_sort carotid plaque score and risk of cardiovascular mortality in the oldest old: results from the tooth study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5770224/
https://www.ncbi.nlm.nih.gov/pubmed/28179606
http://dx.doi.org/10.5551/jat.37911
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