Key result
Measurement of carotid intima-media thickness reclassified 16.5% of asymptomatic patients initially categorized as moderate risk by traditional clinical factors into a higher risk category.
Why the study?
Does CIMT measurement improve cardiovascular risk stratification in asymptomatic individuals at moderate risk?
Cross-Sectional (n=200)
No
Does CIMT measurement improve cardiovascular risk stratification in asymptomatic individuals at moderate risk?
CIMT measurement reclassifies a considerable percentage of asymptomatic individuals at moderate risk based on traditional risk factors alone to a higher risk category.
CIMT may aid further stratification in moderate-risk patients without known CVD; leaves open whether routine use improves outcomes.
BACKGROUND: The 5th Joint Task Force European guidelines on cardiovascular disease (CVD) prevention recommend the measurement of carotid intima-media thickness (CIMT) in asymptomatic individuals at moderate risk (Class IIa). We aimed to evaluate the ability of CIMT to further risk stratify patients. DESIGN: Cross-sectional study. METHODS: Patients aged over 18 years free of known CVD at moderate, high, or very high risk of CVD were included. The Panasonic Cardiohealth station, a semi-automated ultrasound system, was used to detect carotid plaque and measure CIMT. Elevated CIMT was defined as =/> 0.9 mm. We analyzed the percentage of those at moderate risk reclassified after addition of CIMT. RESULTS: Two hundred patients were included (55% women, mean age 57 years, 12% diabetic); 64%, 23% and 13% were classified as moderate, high, and very high risk, respectively. Across these risk categories, 17%, 33%, and 46% had elevated IMT, p for trend < 0.001. With the addition of CIMT, 13.9% (95% CI: 5.7% to 22.1%) of women and 20.4% (95% CI: 8.7% to 32.1%) of men initially moderate risk were reclassified. CONCLUSIONS: CIMT measurement reclassifies a considerable percentage of those at moderate risk based on traditional risk factors alone.
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Cooney et al. (2015) conducted a cross-sectional in Cardiovascular disease risk (n=200). Carotid intima-media thickness (CIMT) measurement vs. Traditional risk factors alone was evaluated on Percentage of moderate risk patients reclassified to a higher risk category after addition of CIMT (95% CI 9.8-23.2). Measurement of carotid intima-media thickness reclassified 16.5% of asymptomatic patients initially categorized as moderate risk by traditional clinical factors into a higher risk category.
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