Analysis For Carotid Atherosclerosis And 10-Year Risk Assessment Of Cardiovascular Diseases In The Physical Examination Population

Objectives: 1、 To investigate the prevalence and risk factors of carotid atherosclerosis(CAS) in the physical examination populations. 2、 To screen for high-risk populations(i.e. statins benefit group in primary prevention) based on the 10-year risk score of cardiovascular diseases(CVD).Methods: A total of 1 065 cases were collected from individuals who received the physical examination in the physical examination center of First Affiliated Hospital of Soochow University among 2013.01~2013.04 and 2015.04~2015.05. We observed the potential risk factors of atherosclerosis(AS), the occurrence of CAS was detected by carotid ultrasound. We detected associated factors of atherosclerosis(AS), recorded the occurrence of CAS by carotid ultrasound. Potential risk factors were examined using Logistic regression models. Chinese ICVD risk assessment model, Pooled Cohort risk assessment model and QRISK2 risk assessment model were used to estimate 10-year CVD risk among those who hadn’t previously been diagnosed with CAS. We examined the degree of diagnostic consistency of the three models in screening for high-risk populations(i.e. statins benefit group in primary prevention).Results: 1、 This study included 1 065 individuals(560 males and 505 females). The incidence of carotid intima-media(IMT) thickening was 14.11% and 3.96% in females and males, respectively. Moreover, the incidence of carotid atherosclerotic plaque formation appeared to be higher in males(30.36%) than in females(13.07%). The incidence of CAS increased along with aging both in male and female(especially in people over 45 years old). 2、 Logistic regression models(OR [95% CI]) revealed several independent risk factor of CAS: aging(11.084 [7.979-15.398]), diabetes history(4.021 [1.906-8.479]), hypertension history(2.583 [1.607-4.152]), smoking history(2.532 [1.208-5.308]), LDL-C≥3.37mmol/L(2.075[1.220-3.529]), male(1.982 [1.014-3.874]). 3、 There were 730 subjects(311 males and 419 females) who had not previously been diagnosed with CAS. We use three assessment models to estimate their 10-year CVD risk. Chinese ICVD risk assessment model: very low risk(94.79%),low risk(3.7%), moderate risk(1.1%),high risk(0.41%),very high risk(0%). Pooled Cohort risk assessment model: high risk(males 36.01%, females 5.25%). QRISK2 risk assessment model: high risk(males 19.29%, females 4.30%). In addition, the proportion of high risk group increased along with aging. 4、 The comparison of three different models: The level of diagnostic consistency between Pooled Cohort risk assessment model and QRISK2 risk assessment model were comparable(Kappa value 0.684, P<0.001). Comparing with two other assessment methods, Chinese ICVD risk assessment model was considered poor in consistency.Conclusions: 1、 The incidence of CAS exhibited an upward trend with age(especially over 45 years old), and male are generally higher than female. It is important for people older than 45 years to have regular physical examinations(including carotid ultrasound and detection of AS risk factors). 2、 Age, gender, diabetes history, hypertension history, LDL-C and smoking history are closely related in the development of CAS. 3、 Further clinical trials are needed to set standards of screen for statins benefit group in primary prevention therapy.