Common carotid artery kinking is a predictor of cardiovascular events: A long-term follow-up study using carotid ultrasonography

Background Kinking of the internal carotid artery is a cardiovascular (CV) risk factor. However, it remains unclear as to whether kinking of the common carotid artery (CCA) can also predict CV events. We conducted a long-term follow-up study to examine whether CCA kinking as assessed by carotid ultrasonography is a predictor of CV events in asymptomatic patients with CV risk factors. Methods We enrolled 598 patients (mean age, 66.8 +/- 11.8 years) who were divided into two groups according to CCA kinking severity: kinking of 0-29 degrees (Group I); and kinking at >= 30 degrees (Group II). We assessed whether CCA kinking predicts CV events during follow-up. Results A total of 91 CV events were observed during the follow-up period (median, 124 months). Hypertension (P < .0001), prior CV events (P < .0001), CCA kinking (P < .0001), intima-media thickness (P < .0001), and max plaque score (P < .0001) were significantly higher in patients with CV events than those without. The age-adjusted hazard ratio of CCA kinking for CV events was 3.42 (95% CI: 2.2-5.3) in Group II compared to Group I. Cox proportional hazard regression analysis revealed that CCA kinking (HR: 3.02, 95% CI: 1.97-4.67), prior CV events (HR: 2.53 95% CI: 1.604.00), hypertension (HR: 2.19 95% CI: 1.17-4.57), and age (HR: 1.04, 95% CI: 1.02-1.07) were independent predictors of CV events. Conclusion CCA kinking is a powerful independent predictor of CV events in asymptomatic patients with CV risk factors.