한국인 뇌졸중 예측모형에 의한 뇌졸중 10년 발생 위험도와 경동맥 내중막 두께의 관련성
The Association Between the 10-Year Risk of the Korean Stroke Risk Prediction Model and the Carotid Intima-Media Thickness
2
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
Background: Both carotid intima-media thickness (IMT) and global risk score of cardiovascular disease were independent risk factors of stroke and heart disease. We assessed the correlation between the 10-year risk of Korean Stroke Risk Prediction model (KSRP) and carotid intima-media thickness. Additionally, from a perspective of carotid IMT measurement following KSRP risk stratification, we analyzed the difference of carotid IMT and plaque according to the KSRP risk strata. Methods: Subjects were 282 persons who visited one hospital for the screening of stroke. The 10-year risk was calculated automatically based on the equation of KSRP model. The maximal carotid IMT and the plaque were adopted as the study variables. The sensitivity and the positive predictive value of the KSRP risk categories were calculated. Results: The correlation coefficient between the KSRP risk and the maximal carotid IMT was 0.29 (p＜0.01). The mean (±standard deviation) of KSRP risk of the group with carotid plaque was statistically significantly higher, 5.3 (±4.1), than that of the group without plaque, 3.3 (±3.1) (p≤0.01). The sensitivity of the risk stratum with more than 6% of KSRP risk for the plaque was 28.2%. The positive predictive value of the above cut-point was 48.8%. Conclusions: The 6% of KSRP risk may be considered as the beginning point of intermediate risk stratum to recommend the carotid ultrasonography. However, generalization needs further studies for various populations.
Abstract
Background: Both carotid intima-media thickness (IMT) and global risk score of cardiovascular disease were independent risk factors of stroke and heart disease. We assessed the correlation between the 10-year risk of Korean Stroke Risk Prediction model (KSRP) and carotid intima-media thickness. Additionally, from a perspective of carotid IMT measurement following KSRP risk stratification, we analyzed the difference of carotid IMT and plaque according to the KSRP risk strata. Methods: Subjects were 282 persons who visited one hospital for the screening of stroke. The 10-year risk was calculated automatically based on the equation of KSRP model. The maximal carotid IMT and the plaque were adopted as the study variables. The sensitivity and the positive predictive value of the KSRP risk categories were calculated. Results: The correlation coefficient between the KSRP risk and the maximal carotid IMT was 0.29 (p＜0.01). The mean (±standard deviation) of KSRP risk of the group with carotid plaque was statistically significantly higher, 5.3 (±4.1), than that of the group without plaque, 3.3 (±3.1) (p≤0.01). The sensitivity of the risk stratum with more than 6% of KSRP risk for the plaque was 28.2%. The positive predictive value of the above cut-point was 48.8%. Conclusions: The 6% of KSRP risk may be considered as the beginning point of intermediate risk stratum to recommend the carotid ultrasonography. However, generalization needs further studies for various populations.
참고문헌 (15)
- Greenland P, "2010 ACCF", AHA guideline for assessment of cardiovascular risk in asymptomatic adults: a report of the American College of Cardiology Foundation, J Am Coll Cardiol, pp.2010, 56[DOI]
- Touboul PJ, "GENIC Investigators. Carotid intima-media thickness, plaques, and Framingham risk Score as independent determinants of stroke risk", Stroke, 36, pp.1741~1745 (2005)
- Jee SH, "Stroke risk prediction model: A risk profile from the Korean study", ATHEROSCLEROSIS, 197, pp.318~325, ELSEVIER IRELAND LTD
- 이지성, "한국인을 위한 뇌졸중 발생 예측모형 개발", 대한신경과학회지, 28(1), pp.13~21 (2010), 대한신경과학회
- Pignoli P, "Intimal plus medial thickness of the arterial wall: a direct measurement with ultrasound imaging", Circulation, 74, pp.1399~1406 (1986)
- Lorenz MW, "Prediction of clinical cardiovascular events with carotid intima-media thickness: a systematic review and meta-analysis", Circulation, 115, pp.459~467 (2007)
- Touboul PJ, "Mannheim carotid intima-media thickness consensus (2004–-2006). An update on behalf of the Advisory Board of the 3rd and 4th Watching the Risk Symposium, 13th and 15th European Stroke Conferences, Mannheim, Germany, 2004, and Brussels, Belgium, 2006", Cerebrovasc Dis, 23, pp.75~80 (2007)
- 방덕원, "관상동맥 질환 환자에서 경동맥 초음파의 유용성", 대한내과학회지, 73(1), pp.11~17 (2007), 대한내과학회
- Kitamura A, "Carotid Intima-media thickness and plaque characteristics as a risk factor for stroke in Japanese elderly men", Stroke, 35, pp.2788~2794 (2004)
- 김기홍, "한국인 관상동맥경화증 환자에서 경동맥 내중막 두께는 프래밍햄 위험 점수와 관련이 있다", Korean Circulation Journal, 37(9), pp.425~431 (2007), 대한심장학회
- Touboul PJ, "Correlation between the Framingham risk score and intima media thickness: the Paroi Artéerielle et Risque Cardio-vasculaire (PARC) study", Atherosclerosis, 192, pp.363~369 (2007)
- 김용재, "경동맥 초음파 : B방식 영상", 대한뇌졸중학회지, 10(2), pp.106~110 (2008), 대한뇌졸중학회
- Goldstein LB, "Guidelines for the Primary Prevention of Stroke:a guideline for healthcare professionals from the American Heart Association", American Stroke Association, 2011, pp.42, 517~584
- Tsutsumi Y, "Carotid ultrasonography" (2007), HanKuk Medical Book
- Baldassarre D, "Carotid artery intima-media thickness measured by ultrasonography in normal clinical practice correlates well with atherosclerosis risk factors", Stroke, 31, pp.2426~2430 (2000)