Objective To screen the high-risk population with cardiovascular and cerebrovascular risk factors using third-generation dual-source low-dose computed tomography (CT) integrative cardio-cerebrovascular imaging (i.e., simultaneous coronary artery and head and neck artery computed tomography angiography (CTA)), and to provide early warning of cardiovascular and cerebrovascular diseases by analyzing the risk factors for the occurrence of vulnerable plaques.

Methods Patients requiring simultaneous coronary artery and head and neck artery CTA were prospectively selected from the Baotou Central Hospital from January 2016 to January 2019, and 614 cases were consecutively included. According to the inclusion and exclusion criteria, 500 patients were selected, including 245 males and 255 females. The age was (57.8±14.2) years. Based on CTA characteristics, the 500 patients were divided into the vulnerable plaque group (200 cases), the stable plaque group (97 cases), and the normal plaque group (203 cases). The stable plaque group and the normal plaque group were called the non-vulnerable plaque group. Through the follow-up of major cardiovascular and cerebrovascular adverse events (MACCE) in patients with vulnerable plaque, the multivariate logistic model was constructed to analyze the vulnerable plaque risk factors and evaluate the plaque block vulnerability. Chi-square test was used to compare the counting data groups. Analysis of variance was used to compare the measurement data with normal distribution between multiple groups. The comparison between two groups of econometric data with skewed distribution used a non parametric U-test, while the comparison between multiple groups used a non parametric Kruskal-Wallis test. Multivariate Logistic regression analysis was used to examine the correlation between vulnerable plaques, risk factors, and MACCE. Two-sample t test was used for the single-factor comparative analysis of indicators between the vulnerable plaque group and the non-vulnerable plaque group.

Results (1) The levels of age, body mass index, blood glucose, homocysteine, triglyceride, low-density lipoprotein, apolipoprotein E, lipoprotein, cystatin C, C-reactive protein, erythrocyte sedimentation rate, and glycosylated hemoglobin c in the vulnerable plaque group were significantly higher than those in the non-vulnerable plaque group, and the differences were statistically significant (t=2.267−24.930, all P<0.05). The incidence of MACCE, hypertension, diabetes, coronary heart disease in the vulnerable plaque group were higher than those in the non-vulnerable plaque group, and the differences were statistically significant (χ²=10.349−102.667, all P<0.05). High-density lipoprotein, lactate dehydrogenase, and the level of creatine kinase were significantly lower in the vulnerable plaque group than those in the non-vulnerable plaque group, and the differences were statistically significant (t=4.062, 2.965, Z=−2.065; all P<0.05). (2) Age (OR=1.027, 95%CI: 1.004–1.052), hypertension (OR=1.654, 95%CI: 1.026–2.667), glycosuria (OR=2.488, 95%CI: 1.370–4.517), hyperglycemia (OR=1.227, 95%CI: 1.100–1.368), homocysteine (OR=1.078, 95%CI: 1.020–1.140), and C-reactive protein (OR=2.011, 95%CI: 1.022–3.958) were risk factors for vulnerable plaques. (3) Compared with the non-vulnerable plaque group, the onset of MACCE in the vulnerable plaque group was earlier ((1.1±0.3) years vs. (0.8±0.2) years), and the patients were younger ((59.9±13.7) years vs. (54.1±8.5) years). All the differences were statistically significant (t=7.775, P<0.001; t=2.059, P=0.043). (4) More patients with MACCE had multiple signs of vulnerable plaques. (5) The probability of MACCE in patients with vulnerable plaque was 7.637 times higher than that in patients without vulnerable plaque. Vulnerable plaque was an independent risk factor for MACCE (OR=7.637, 95%CI: 5.047–11.554).

Conclusion The third-generation dual-source low-dose CT integrated cardio-cerebrovascular imaging is of great value for the early warning of cardiovascular and cerebrovascular diseases.