Common Carotid Intima-Media Thickness and Framingham Risk Score Predict Incident Carotid Atherosclerotic Plaque Formation Longitudinal Results From the Study of Health in Pomerania

• Published in: Stroke (1970) Vol. 41; no. 10; pp. 2375 - 2377
• Main Authors: von Sarnowski, Bettina, Lüdemann, Jan, Völzke, Henry, Dörr, Marcus, Kessler, Christof, Schminke, Ulf
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 01.10.2010
• Subjects: Aged; Aged, 80 and over; Atherosclerosis (general aspects, experimental research); Atherosclerosis - diagnostic imaging; Atherosclerosis - epidemiology; Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Carotid Artery Diseases - diagnostic imaging; Carotid Artery Diseases - epidemiology; Carotid Artery, Common - diagnostic imaging; Health Surveys; Humans; Longitudinal Studies; Medical sciences; Middle Aged; Neurology; Prevalence; Regression Analysis; Risk; Risk Factors; Tunica Intima - diagnostic imaging; Tunica Media - diagnostic imaging; Ultrasonography; Vascular diseases and vascular malformations of the nervous system; Stroke; Nervous system diseases; intima media thickness; Cardiovascular disease; carotid plaque; Epidemiology; Cerebral disorder; Vascular disease; Common carotid; Atherosclerotic plaque; Central nervous system disease; Atherosclerosis; Risk factor; Cerebrovascular disease
• ISSN: 0039-2499; 1524-4628; 1524-4628
• DOI: 10.1161/STROKEAHA.110.593244

Background and Purpose— Cross-sectional studies describe a positive association between common carotid artery intima-media thickness (CCA-IMT) and carotid plaques (CP). However, longitudinal data on the predictive value of CCA-IMT for occurrence of CP are limited. Therefore, the role of increasing CCA-IMT in the atherosclerotic process is still discussed controversially. Methods— We investigated the predictive value of CCA-IMT and the Framingham risk score (FRS) for incident CP formation in a population-based longitudinal study of 1922 subjects aged 45 to 81 years who underwent ultrasonography of both carotid arteries and received vascular risk factor assessment at baseline and after 5 years. CP was defined as any protruding focal thickening of the intima-media complex. Incident CP formation during follow-up was defined as the appearance of at least 1 CP in a previously plaque-free arterial segment (right and left common, internal, and external carotid arteries and carotid bifurcation). Results— Among the 636 subjects without CP at baseline, 418 (66%) had at least 1 incident CP during follow-up. In a multivariable negative binominal regression model adjusted for age, gender, and the FRS, the number of arterial segments affected by incident CP was 1.53-fold higher (CI, 1.12–2.07; P <0.01) for subjects in the highest quartile of the overall CCA-IMT distribution compared to those in the lowest quartile. Conclusions— Both CCA-IMT and FRS independently predict incident CP formation. The risk of CP formation may actually be underestimated in subjects with low FRS and high IMT.