The Value of Carotid Intima-Media Thickness for Predicting Cardiovascular Risk

• Published in: Arteriosclerosis, thrombosis, and vascular biology Vol. 30; no. 2; pp. 182 - 185
• Main Authors: Simon, Alain, Megnien, Jean-Louis, Chironi, Gilles
• Format: Journal Article
• Language: English
• Published: Philadelphia, PA American Heart Association, Inc 01.02.2010; Lippincott Williams & Wilkins
• Subjects: Adult; Aged; Aged, 80 and over; Atherosclerosis (general aspects, experimental research); Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Cardiovascular Diseases - diagnostic imaging; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - etiology; Carotid Arteries - diagnostic imaging; Carotid Artery Diseases - complications; Carotid Artery Diseases - diagnostic imaging; Carotid Artery Diseases - epidemiology; Coronary heart disease; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Female; Heart; Humans; Male; Medical sciences; Middle Aged; Predictive Value of Tests; Prognosis; Risk Assessment; Risk Factors; Severity of Illness Index; Tunica Intima - diagnostic imaging; Tunica Media - diagnostic imaging; Ultrasonography; coronary heart disease risk; Nervous system diseases; Stroke; ultrasonography; Cardiovascular disease; Coronary heart disease; carotid intima-media thickness; Artery; Cerebral disorder; Vascular disease; Blood vessel; Carotid; Central nervous system disease; Atherosclerosis; Echography; Risk factor; Circulatory system; Cerebrovascular disease
• ISSN: 1079-5642; 1524-4636; 1524-4636
• DOI: 10.1161/ATVBAHA.109.196980

We reviewed prospective epidemiological data in the general population, mostly middle-aged to older persons, to determine the association of carotid intima-media thickness (CIMT) (assessed by B-mode ultrasonography) with cardiovascular risk. Reported risks were expressed as absolute (event risk per persons-years in subjects with a high CIMT) and relative (hazard ratio of high vs low CIMT). They were hardly comparable as the result of differences between the analyzed studies, including the site and procedure of CIMT measurement, the report of adjusted or unadjusted models, and the arbitrary cutoff point to evaluate the CIMT ability to predict risk. Despite these heterogeneities, the following four main conclusions emerged(1) CIMT was an independent but relatively modest (as judged by absolute risk) predictor of coronary heart disease (CHD); (2) CIMT was an independent predictor for stroke, slightly better than for CHD as judged by the relative risks of both events; (3) CIMT added little to the CHD prediction by risk factors, as judged by c statistic and receiver operating characteristic curve analysis (however, appropriate data for stroke on this important issue were lacking); and (4) the CHD prediction by CIMT was inferior to that by ultrasonography-assessed carotid plaque because plaque may be more representative of atherosclerosis than CIMT.