Key result
Higher carotid intima-media thickness was associated with a higher rate of composite cardiovascular events (P=0.049), but was not an independent predictor after adjustment for age and gender.
Why the study?
In patients with high cardiovascular risk or established cardiovascular disease, the impact of carotid intima-media thickness measurement on risk stratification for future events is less clear than in intermediate-risk patients.
Does higher carotid intima-media thickness predict cardiovascular events in patients with high cardiovascular risk?
Cohort (n=296)
Does higher carotid intima-media thickness predict cardiovascular events in patients with high cardiovascular risk?
p-value: p=0.049
CIMT is associated with worse outcomes in high cardiovascular risk patients, but this association is mainly driven by age and gender, limiting its independent prognostic value.
BACKGROUND: Carotid intima-media thickness (CIMT) is an established surrogate marker for cardiovascular events in patients with intermediate risk. In patients with high cardiovascular risk or established cardiovascular disease, the impact of CMIT measurement on risk stratification for future events is less clear. Our objective was to evaluate the impact of CIMT on the occurrence of cardiovascular events in a cohort of individuals with high cardiovascular risk, in long-term follow-up. METHODS: We analyzed 296 individuals, mean follow-up of 6.9 ± 2.2 years. Individuals were divided into tertiles according to CIMT. Tertiles were compared in terms of baseline characteristics and outcomes during follow-up-all-cause mortality and composite outcome (mortality, acute coronary syndromes, coronary revascularization, stroke/transient ischemic attack, heart failure, or cardiovascular admission). RESULTS: Our population had a mean age of 65 ± 9 years at the beginning of the study, 55% males. Patients with higher CIMT showed a trend for higher cardiovascular mortality (P = 0.084) and for the composite outcome (P = 0.049). A CIMT ≥ 0.85 mm was also associated with higher rate of events; however, CIMT was not an independent predictor of outcome after adjustment for age and gender. CIMT assessment was useful in patients with hypertension, hyperlipidemia, and metabolic syndrome and in nondiabetic patients. For the composite outcome, it was also useful in females, smokers, and in patients without coronary artery disease. CONCLUSIONS: Patients with higher CIMT have worst outcome, but this was mainly driven by age and gender. CIMT is useful as a prognostic marker in specific subsets of patients.
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Timóteo et al. (2018) conducted a cohort in high cardiovascular risk (n=296). Carotid intima-media thickness (CIMT) vs. Lower CIMT was evaluated on composite outcome (mortality, acute coronary syndromes, coronary revascularization, stroke/transient ischemic attack, heart failure, or cardiovascular admission) (p=0.049). Higher carotid intima-media thickness was associated with a higher rate of composite cardiovascular events (P=0.049), but was not an independent predictor after adjustment for age and gender.
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