@article {1382, title = {Carotid intima-media thickness progression to predict cardiovascular events in the general population (the PROG-IMT collaborative project): a meta-analysis of individual participant data.}, journal = {Lancet}, volume = {379}, year = {2012}, month = {2012 Jun 02}, pages = {2053-62}, abstract = {

BACKGROUND: Carotid intima-media thickness (cIMT) is related to the risk of cardiovascular events in the general population. An association between changes in cIMT and cardiovascular risk is frequently assumed but has rarely been reported. Our aim was to test this association.

METHODS: We identified general population studies that assessed cIMT at least twice and followed up participants for myocardial infarction, stroke, or death. The study teams collaborated in an individual participant data meta-analysis. Excluding individuals with previous myocardial infarction or stroke, we assessed the association between cIMT progression and the risk of cardiovascular events (myocardial infarction, stroke, vascular death, or a combination of these) for each study with Cox regression. The log hazard ratios (HRs) per SD difference were pooled by random effects meta-analysis.

FINDINGS: Of 21 eligible studies, 16 with 36,984 participants were included. During a mean follow-up of 7{\textperiodcentered}0 years, 1519 myocardial infarctions, 1339 strokes, and 2028 combined endpoints (myocardial infarction, stroke, vascular death) occurred. Yearly cIMT progression was derived from two ultrasound visits 2-7 years (median 4 years) apart. For mean common carotid artery intima-media thickness progression, the overall HR of the combined endpoint was 0{\textperiodcentered}97 (95\% CI 0{\textperiodcentered}94-1{\textperiodcentered}00) when adjusted for age, sex, and mean common carotid artery intima-media thickness, and 0{\textperiodcentered}98 (0{\textperiodcentered}95-1{\textperiodcentered}01) when also adjusted for vascular risk factors. Although we detected no associations with cIMT progression in sensitivity analyses, the mean cIMT of the two ultrasound scans was positively and robustly associated with cardiovascular risk (HR for the combined endpoint 1{\textperiodcentered}16, 95\% CI 1{\textperiodcentered}10-1{\textperiodcentered}22, adjusted for age, sex, mean common carotid artery intima-media thickness progression, and vascular risk factors). In three studies including 3439 participants who had four ultrasound scans, cIMT progression did not correlate between occassions (reproducibility correlations between r=-0{\textperiodcentered}06 and r=-0{\textperiodcentered}02).

INTERPRETATION: The association between cIMT progression assessed from two ultrasound scans and cardiovascular risk in the general population remains unproven. No conclusion can be derived for the use of cIMT progression as a surrogate in clinical trials.

FUNDING: Deutsche Forschungsgemeinschaft.

}, keywords = {Cardiovascular Diseases, Carotid Intima-Media Thickness, Disease Progression, Follow-Up Studies, Humans, Myocardial Infarction, Prognosis, Risk Assessment, Stroke}, issn = {1474-547X}, doi = {10.1016/S0140-6736(12)60441-3}, author = {Lorenz, Matthias W and Polak, Joseph F and Kavousi, Maryam and Mathiesen, Ellisiv B and V{\"o}lzke, Henry and Tuomainen, Tomi-Pekka and Sander, Dirk and Plichart, Matthieu and Catapano, Alberico L and Robertson, Christine M and Kiechl, Stefan and Rundek, Tatjana and Desvarieux, Mo{\"\i}se and Lind, Lars and Schmid, Caroline and DasMahapatra, Pronabesh and Gao, Lu and Ziegelbauer, Kathrin and Bots, Michiel L and Thompson, Simon G} } @article {7846, title = {Predictive value for cardiovascular events of common carotid intima media thickness and its rate of change in individuals at high cardiovascular risk - Results from the PROG-IMT collaboration.}, journal = {PLoS One}, volume = {13}, year = {2018}, month = {2018}, pages = {e0191172}, abstract = {

AIMS: Carotid intima media thickness (CIMT) predicts cardiovascular (CVD) events, but the predictive value of CIMT change is debated. We assessed the relation between CIMT change and events in individuals at high cardiovascular risk.

METHODS AND RESULTS: From 31 cohorts with two CIMT scans (total n = 89070) on average 3.6 years apart and clinical follow-up, subcohorts were drawn: (A) individuals with at least 3 cardiovascular risk factors without previous CVD events, (B) individuals with carotid plaques without previous CVD events, and (C) individuals with previous CVD events. Cox regression models were fit to estimate the hazard ratio (HR) of the combined endpoint (myocardial infarction, stroke or vascular death) per standard deviation (SD) of CIMT change, adjusted for CVD risk factors. These HRs were pooled across studies. In groups A, B and C we observed 3483, 2845 and 1165 endpoint events, respectively. Average common CIMT was 0.79mm (SD 0.16mm), and annual common CIMT change was 0.01mm (SD 0.07mm), both in group A. The pooled HR per SD of annual common CIMT change (0.02 to 0.43mm) was 0.99 (95\% confidence interval: 0.95-1.02) in group A, 0.98 (0.93-1.04) in group B, and 0.95 (0.89-1.04) in group C. The HR per SD of common CIMT (average of the first and the second CIMT scan, 0.09 to 0.75mm) was 1.15 (1.07-1.23) in group A, 1.13 (1.05-1.22) in group B, and 1.12 (1.05-1.20) in group C.

CONCLUSIONS: We confirm that common CIMT is associated with future CVD events in individuals at high risk. CIMT change does not relate to future event risk in high-risk individuals.

}, keywords = {Aged, Cardiovascular Diseases, Carotid Intima-Media Thickness, Female, Humans, Intersectoral Collaboration, Male, Middle Aged, Prognosis, Risk Factors}, issn = {1932-6203}, doi = {10.1371/journal.pone.0191172}, author = {Lorenz, Matthias W and Gao, Lu and Ziegelbauer, Kathrin and Norata, Giuseppe Danilo and Empana, Jean Philippe and Schmidtmann, Irene and Lin, Hung-Ju and McLachlan, Stela and Bokemark, Lena and Ronkainen, Kimmo and Amato, Mauro and Schminke, Ulf and Srinivasan, Sathanur R and Lind, Lars and Okazaki, Shuhei and Stehouwer, Coen D A and Willeit, Peter and Polak, Joseph F and Steinmetz, Helmuth and Sander, Dirk and Poppert, Holger and Desvarieux, Mo{\"\i}se and Ikram, M Arfan and Johnsen, Stein Harald and Staub, Daniel and Sirtori, Cesare R and Iglseder, Bernhard and Beloqui, Oscar and Engstr{\"o}m, Gunnar and Friera, Alfonso and Rozza, Francesco and Xie, Wuxiang and Parraga, Grace and Grigore, Liliana and Plichart, Matthieu and Blankenberg, Stefan and Su, Ta-Chen and Schmidt, Caroline and Tuomainen, Tomi-Pekka and Veglia, Fabrizio and V{\"o}lzke, Henry and Nijpels, Giel and Willeit, Johann and Sacco, Ralph L and Franco, Oscar H and Uthoff, Heiko and Hedblad, Bo and Suarez, Carmen and Izzo, Raffaele and Zhao, Dong and Wannarong, Thapat and Catapano, Alberico and Ducimetiere, Pierre and Espinola-Klein, Christine and Chien, Kuo-Liong and Price, Jackie F and Bergstr{\"o}m, G{\"o}ran and Kauhanen, Jussi and Tremoli, Elena and D{\"o}rr, Marcus and Berenson, Gerald and Kitagawa, Kazuo and Dekker, Jacqueline M and Kiechl, Stefan and Sitzer, Matthias and Bickel, Horst and Rundek, Tatjana and Hofman, Albert and Mathiesen, Ellisiv B and Castelnuovo, Samuela and Landecho, Manuel F and Rosvall, Maria and Gabriel, Rafael and de Luca, Nicola and Liu, Jing and Baldassarre, Damiano and Kavousi, Maryam and de Groot, Eric and Bots, Michiel L and Yanez, David N and Thompson, Simon G} }