TY - JOUR
T1 - Intima-media thickness at the near or far wall of the common carotid artery in cardiovascular risk assessment
AU - Seekircher, Lisa
AU - Tschiderer, Lena
AU - Lind, Lars
AU - Safarova, Maya S.
AU - Kavousi, Maryam
AU - Ikram, M. Arfan
AU - Lonn, Eva
AU - Yusuf, Salim
AU - Grobbee, Diederick E.
AU - Kastelein, John J. P.
AU - Visseren, Frank L. J.
AU - Walters, Matthew
AU - Dawson, Jesse
AU - Higgins, Peter
AU - Agewall, Stefan
AU - Catapano, Alberico
AU - de Groot, Eric
AU - Espeland, Mark A.
AU - Klingenschmid, Gerhard
AU - Magliano, Dianna
AU - Olsen, Michael H.
AU - Preiss, David
AU - Sander, Dirk
AU - Skilton, Michael
AU - Zozulińska-Ziółkiewicz, Dorota A.
AU - Grooteman, Muriel P. C.
AU - Blankestijn, Peter J.
AU - Kitagawa, Kazuo
AU - Okazaki, Shuhei
AU - Manzi, Maria V.
AU - Mancusi, Costantino
AU - Izzo, Raffaele
AU - Desvarieux, Moise
AU - Rundek, Tatjana
AU - Gerstein, Hertzel C.
AU - Bots, Michiel L.
AU - Sweeting, Michael J.
AU - Lorenz, Matthias W.
AU - Willeit, Peter
N1 - Funding Information: This paper was prepared using data of the Atherosclerosis Risk in Communities Study (ARIC), the Cardiovascular Health Study (CHS), and the Jackson Heart Study (JHS) obtained from the NHLBI Biologic Specimen and Data Repository Information Coordinating Center (BioLINCC) and does not necessarily reflect the opinions or views of the ARIC, CHS, JHS, or NHLBI. The work of AC is supported in part by Ministero della Salute ricerca corrente. Results of this paper are included in the first author’s (L.S.) PhD thesis submitted at the Medical University of Innsbruck. Funding Information: This work was supported by the Austrian Science Fund (FWF; P 32488) and the Dr. Johannes-and-Hertha-Tuba Foundation. Publisher Copyright: © 2023 The Author(s). Published by Oxford University Press on behalf of the European Society of Cardiology.
PY - 2023/9/1
Y1 - 2023/9/1
N2 - 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.
AB - 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.
KW - Cardiovascular risk
KW - Common carotid artery intima-media thickness
KW - Individual-participant-data meta-analysis
UR - http://www.scopus.com/inward/record.url?scp=85175624427&partnerID=8YFLogxK
U2 - https://doi.org/10.1093/ehjopen/oead089
DO - https://doi.org/10.1093/ehjopen/oead089
M3 - Article
C2 - 37840587
SN - 2752-4191
VL - 3
JO - European heart journal open
JF - European heart journal open
IS - 5
M1 - oead089
ER -