What question did this study set out to answer?

To assess the predictive value of common carotid intima-media thickness (CIMT) and its rate of progression for future cardiovascular events in individuals at high cardiovascular risk.

April 12, 2018PLoS ONEOpen Access

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

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Why the study?

Does the rate of change in common carotid intima media thickness (CIMT) predict cardiovascular events in individuals at high cardiovascular risk?

Key Points

To assess the predictive value of common carotid intima-media thickness (CIMT) and its rate of progression for future cardiovascular events in individuals at high cardiovascular risk.
Analyzed individual participant data from 31 cohorts (total N=89,070) with two ultrasound scans performed an average of 3.6 years apart followed by clinical surveillance.
Stratified subjects into three high-risk subcohorts: individuals with ≥3 risk factors without prior CVD (Group A), individuals with carotid plaques without prior CVD (Group B), and individuals with prior CVD events (Group C).
Calculated pooled multivariable-adjusted hazard ratios (HR) per standard deviation (SD) for a composite endpoint of myocardial infarction, stroke, or vascular death using Cox regression.
Annual common CIMT change was not associated with future cardiovascular events in Group A (pooled HR 0.99, 95% CI: 0.95–1.02; 3,483 events), Group B (pooled HR 0.98, 95% CI: 0.93–1.04; 2,845 events), or Group C (pooled HR 0.95, 95% CI: 0.89–1.04; 1,165 events).
Average baseline common CIMT consistently predicted cardiovascular events across all groups, with pooled HRs per SD of 1.15 (95% CI: 1.07–1.23) in Group A, 1.13 (95% CI: 1.05–1.22) in Group B, and 1.12 (95% CI: 1.05–1.20) in Group C.

Structured PICO

Does the rate of change in common carotid intima media thickness (CIMT) predict cardiovascular events in individuals at high cardiovascular risk?

Population

89,070 individuals from 31 cohorts with two CIMT scans on average 3.6 years apart and clinical follow-up, divided into subcohorts: (A) ≥3 CV risk factors without previous CVD events, (B) carotid plaques without previous CVD events, and (C) previous CVD events.

Intervention

Common carotid intima media thickness (CIMT) and its rate of change

Outcome

Combined endpoint of myocardial infarction, stroke or vascular deathcomposite

Baseline common CIMT predicts future cardiovascular events in high-risk individuals, but the rate of CIMT change does not provide additional predictive value.

Discussion

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Implication

CIMT progression adds no predictive value beyond baseline in high-risk patients; confirms baseline CIMT relevance without benefit from serial change.

Cite This Study

Lorenz et al. (2018) studied this question.

synapsesocial.com/papers/6a82328280b3939dcdca37b1 https://doi.org/10.1371/journal.pone.0191172

Topics

Women and heart disease

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Implication

CIMT progression adds no predictive value beyond baseline in high-risk patients; confirms baseline CIMT relevance without benefit from serial change.

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

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Topics

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

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider