TY - JOUR
T1 - Carotid plaque score and risk of cardiovascular mortality in the oldest old
T2 - Results from the TOOTH study
AU - Hirata, Takumi
AU - Arai, Yasumichi
AU - Takayama, Michiyo
AU - Abe, Yukiko
AU - Ohkuma, Kiyoshi
AU - Takebayashi, Toru
N1 - Funding Information:
Arai received research grant funding from Dai-ichi Sankyo Company, Limited. All other authors have nothing to disclose.
Funding Information:
We thank the participants and their families for their time and personal information, and Ms. Miho Shimura for her kind assistance.The TOOTH study is funded by a Grant-in-Aid for Scientific Research (C) (No 20590706, 21590775) from the Japan Society for the Promotion of Science, the medical-welfare-food-agriculture collaborating consortium project from the Japan Ministry of Agriculture, Forestry, and Fisheries, a grant from the Novartis Foundation for Gerontological Research, a grant from the Foundation for Total Health Promotion, and the Chiyoda Mutual Life Foundation. The funding agencies had no direct role in the design or conduct of the study; the collection, management, analysis, or interpretation of the data; or the preparation or approval of the manuscript.
Funding Information:
The TOOTH study is funded by a Grant-in-Aid for Scientific Research (C) (No 20590706, 21590775) from the Japan Society for the Promotion of Science, the medical-welfare-food-agriculture collaborating consortium project from the Japan Ministry of Agriculture, Forestry, and Fisheries, a grant from the Novartis Foundation for Gerontological Research, a grant from the Foundation for Total Health Promotion, and the Chiyoda Mutual Life Foundation. The funding agencies had no direct role in the design or conduct of the study; the collection, management, analysis, or interpretation of the data; or the preparation or approval of the manuscript.
Publisher Copyright:
© 2018 Japan Atherosclerosis Society.
PY - 2018
Y1 - 2018
N2 - 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.
AB - 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.
KW - Asymmetrical dimethylarginine
KW - Cardiovascular disease
KW - Carotid plaque score
KW - Epidemiology
KW - Oldest old
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UR - http://www.scopus.com/inward/citedby.url?scp=85042668782&partnerID=8YFLogxK
U2 - 10.5551/jat.37911
DO - 10.5551/jat.37911
M3 - Article
C2 - 28179606
AN - SCOPUS:85042668782
SN - 1340-3478
VL - 25
SP - 55
EP - 64
JO - Journal of atherosclerosis and thrombosis
JF - Journal of atherosclerosis and thrombosis
IS - 1
ER -
