Lisa Seekircher, Lena Tschiderer, Lars Lind, Maya S Safarova, Maryam Kavousi, M Arfan Ikram, Eva Lonn, Salim Yusuf, Diederick E Grobbee, John J P Kastelein, Frank L J Visseren, Matthew Walters, Jesse Dawson, Peter Higgins, Stefan Agewall, Alberico Catapano, Eric de Groot, Mark A Espeland, Gerhard Klingenschmid, Dianna Magliano, Michael H Olsen, David Preiss, Dirk Sander, Michael Skilton, Dorota A Zozulińska-Ziółkiewicz, Muriel P C Grooteman, Peter J Blankestijn, Kazuo Kitagawa, Shuhei Okazaki, Maria V Manzi, Costantino Mancusi, Raffaele Izzo, Moise Desvarieux, Tatjana Rundek, Hertzel C Gerstein, Michiel L Bots, Michael J Sweeting, Matthias W Lorenz, Peter Willeit
{"title":"Intima-media thickness at the near or far wall of the common carotid artery in cardiovascular risk assessment.","authors":"Lisa Seekircher, Lena Tschiderer, Lars Lind, Maya S Safarova, Maryam Kavousi, M Arfan Ikram, Eva Lonn, Salim Yusuf, Diederick E Grobbee, John J P Kastelein, Frank L J Visseren, Matthew Walters, Jesse Dawson, Peter Higgins, Stefan Agewall, Alberico Catapano, Eric de Groot, Mark A Espeland, Gerhard Klingenschmid, Dianna Magliano, Michael H Olsen, David Preiss, Dirk Sander, Michael Skilton, Dorota A Zozulińska-Ziółkiewicz, Muriel P C Grooteman, Peter J Blankestijn, Kazuo Kitagawa, Shuhei Okazaki, Maria V Manzi, Costantino Mancusi, Raffaele Izzo, Moise Desvarieux, Tatjana Rundek, Hertzel C Gerstein, Michiel L Bots, Michael J Sweeting, Matthias W Lorenz, Peter Willeit","doi":"10.1093/ehjopen/oead089","DOIUrl":null,"url":null,"abstract":"<p><strong>Aims: </strong>Current guidelines recommend measuring carotid intima-media thickness (IMT) at the far wall of the common carotid artery (CCA). We aimed to precisely quantify associations of near vs. far wall CCA-IMT with the risk for atherosclerotic cardiovascular disease (CVD, defined as coronary heart disease or stroke) and their added predictive values.</p><p><strong>Methods and results: </strong>We analysed individual records of 41 941 participants from 16 prospective studies in the Proof-ATHERO consortium {mean age 61 years [standard deviation (SD) = 11]; 53% female; 16% prior CVD}. Mean baseline values of near and far wall CCA-IMT were 0.83 (SD = 0.28) and 0.82 (SD = 0.27) mm, differed by a mean of 0.02 mm (95% limits of agreement: -0.40 to 0.43), and were moderately correlated [<i>r</i> = 0.44; 95% confidence interval (CI): 0.39-0.49). Over a median follow-up of 9.3 years, we recorded 10 423 CVD events. We pooled study-specific hazard ratios for CVD using random-effects meta-analysis. Near and far wall CCA-IMT values were approximately linearly associated with CVD risk. The respective hazard ratios per SD higher value were 1.18 (95% CI: 1.14-1.22; <i>I</i>² = 30.7%) and 1.20 (1.18-1.23; <i>I</i>² = 5.3%) when adjusted for age, sex, and prior CVD and 1.09 (1.07-1.12; <i>I</i>² = 8.4%) and 1.14 (1.12-1.16; <i>I</i>²=1.3%) upon multivariable adjustment (all <i>P</i> < 0.001). Assessing CCA-IMT at both walls provided a greater C-index improvement than assessing CCA-IMT at one wall only [+0.0046 vs. +0.0023 for near (<i>P</i> < 0.001), +0.0037 for far wall (<i>P</i> = 0.006)].</p><p><strong>Conclusions: </strong>The associations of near and far wall CCA-IMT with incident CVD were positive, approximately linear, and similarly strong. Improvement in risk discrimination was highest when CCA-IMT was measured at both walls.</p>","PeriodicalId":93995,"journal":{"name":"European heart journal open","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2023-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/03/c1/oead089.PMC10575622.pdf","citationCount":"1","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European heart journal open","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1093/ehjopen/oead089","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/9/1 0:00:00","PubModel":"eCollection","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 1
Abstract
Aims: Current guidelines recommend measuring carotid intima-media thickness (IMT) at the far wall of the common carotid artery (CCA). We aimed to precisely quantify associations of near vs. far wall CCA-IMT with the risk for atherosclerotic cardiovascular disease (CVD, defined as coronary heart disease or stroke) and their added predictive values.
Methods and results: We analysed individual records of 41 941 participants from 16 prospective studies in the Proof-ATHERO consortium {mean age 61 years [standard deviation (SD) = 11]; 53% female; 16% prior CVD}. Mean baseline values of near and far wall CCA-IMT were 0.83 (SD = 0.28) and 0.82 (SD = 0.27) mm, differed by a mean of 0.02 mm (95% limits of agreement: -0.40 to 0.43), and were moderately correlated [r = 0.44; 95% confidence interval (CI): 0.39-0.49). Over a median follow-up of 9.3 years, we recorded 10 423 CVD events. We pooled study-specific hazard ratios for CVD using random-effects meta-analysis. Near and far wall CCA-IMT values were approximately linearly associated with CVD risk. The respective hazard ratios per SD higher value were 1.18 (95% CI: 1.14-1.22; I² = 30.7%) and 1.20 (1.18-1.23; I² = 5.3%) when adjusted for age, sex, and prior CVD and 1.09 (1.07-1.12; I² = 8.4%) and 1.14 (1.12-1.16; I²=1.3%) upon multivariable adjustment (all P < 0.001). Assessing CCA-IMT at both walls provided a greater C-index improvement than assessing CCA-IMT at one wall only [+0.0046 vs. +0.0023 for near (P < 0.001), +0.0037 for far wall (P = 0.006)].
Conclusions: The associations of near and far wall CCA-IMT with incident CVD were positive, approximately linear, and similarly strong. Improvement in risk discrimination was highest when CCA-IMT was measured at both walls.
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