A Risk Score for the Prediction of Carotid Atherosclerosis in the general urban population

2019 Fiscal Year Final Research Report

• Project/Area Number: 17K19873
• Research Category: Grant-in-Aid for Challenging Research (Exploratory)
• Allocation Type: Multi-year Fund
• Research Field: Society medicine, Nursing, and related fields
• Research Institution: National Cardiovascular Center Research Institute
• Principal Investigator: Kokubo Yoshihiro 国立研究開発法人国立循環器病研究センター, 病院, 医長 (20393217)
• Project Period (FY): 2017-06-30 – 2020-03-31
• Keywords: 頸動脈硬化 / プラーク進展 / 循環器病 / 追跡研究 / 危険因子 / リスクスコア

Outline of Final Research Achievements

No prospective study of the relationship between IMT progression and incident CVD has been performed. We studied 4724 participants without CVD who had carotid ultrasonography. Carotid ultrasonographic follow-up was performed every 2 years, newly revealing 193 CCA plaques. During the 59,909 person-years of follow-up, we observed 221 strokes and 154 CHD events. CCA plaque was a risk factor for CVD. Also, we developed a scoring system for each risk factor as follows: 2, 4, 6, 9, and 11 points for age 40's to 80's; -1 point for women; 1, and 2 points for SBP=120-159, and ≧160mmHg; 1, 2, and 3 points for TC=160-239, 240-279, and ≧280mg/dL; 2, and -1 points for HDLC<35 and ≧60mg/dL; 1 point for overweight or current smoking; and 2 points for diabetes. In conclusion, this study provides the first demonstration that new progression of incident CCA plaque is a CVD risk. We have developed a 10-year risk score for the plaque in routine health examinations and outpatients.

Free Research Field

予防医学

Academic Significance and Societal Importance of the Research Achievements

生活習慣の改善のポイントや動脈硬化罹病のリスクスコアーを世界で初めて示すことが出来るため、動脈硬化ガイドラインなどで引用でき、動脈硬化予防に大きく寄与することが可能な研究といえる。これらのエビデンスを用いて、頸動脈エコー検査を実施せずとも、健診や外来のデータを用いてプラーク進展の予測確率を簡便に掲載できることが可能となる。