Advanced

Prediction of clinical cardiovascular events with carotid intima-media thickness: a systematic review and meta-analysis.

Lorenz, Matthias W; Markus, Hugh S; Bots, Michiel L; Rosvall, Maria LU and Sitzer, Matthias (2007) In Circulation 115(4). p.459-467
Abstract
Background— Carotid intima-media thickness (IMT) is increasingly used as a surrogate marker for atherosclerosis. Its use relies on its ability to predict future clinical cardiovascular end points. We performed a systematic review and meta-analysis of data to examine this association.



Methods and Results— Using a prespecified search strategy, we identified 8 relevant studies and compared study design, measurement protocols, and reported data. We identified sources of heterogeneity between studies. The assumption of a linear relationship between IMT and risk was challenged by use of a graphical technique. To obtain a pooled estimate of the relative risk per IMT difference, we performed a meta-analysis based on random... (More)
Background— Carotid intima-media thickness (IMT) is increasingly used as a surrogate marker for atherosclerosis. Its use relies on its ability to predict future clinical cardiovascular end points. We performed a systematic review and meta-analysis of data to examine this association.



Methods and Results— Using a prespecified search strategy, we identified 8 relevant studies and compared study design, measurement protocols, and reported data. We identified sources of heterogeneity between studies. The assumption of a linear relationship between IMT and risk was challenged by use of a graphical technique. To obtain a pooled estimate of the relative risk per IMT difference, we performed a meta-analysis based on random effects models. The age- and sex-adjusted overall estimates of the relative risk of myocardial infarction were 1.26 (95% CI, 1.21 to 1.30) per 1–standard deviation common carotid artery IMT difference and 1.15 (95% CI, 1.12 to 1.17) per 0.10-mm common carotid artery IMT difference. The age- and sex-adjusted relative risks of stroke were 1.32 (95% CI, 1.27 to 1.38) per 1–standard deviation common carotid artery IMT difference and 1.18 (95% CI, 1.16 to 1.21) per 0.10-mm common carotid artery IMT difference. Major sources of heterogeneity were age distribution, carotid segment definition, and IMT measurement protocol. The relationship between IMT and risk was nonlinear, but the linear models fitted relatively well for moderate to high IMT values.



Conclusions— Carotid IMT is a strong predictor of future vascular events. The relative risk per IMT difference is slightly higher for the end point stroke than for myocardial infarction. In future IMT studies, ultrasound protocols should be aligned with published studies. Data for younger individuals are limited and more studies are required. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
myocardial infarction, atherosclerosis, meta-analysis, stroke, carotid arteries
in
Circulation
volume
115
issue
4
pages
459 - 467
publisher
Lippincott Williams and Wilkins
external identifiers
  • wos:000243853400009
  • scopus:33846609195
ISSN
1524-4539
DOI
10.1161/CIRCULATIONAHA.106.628875
language
English
LU publication?
yes
id
6917c006-6952-4d15-b954-af24867ea048 (old id 164704)
date added to LUP
2007-07-24 15:54:49
date last changed
2017-11-19 04:07:20
@article{6917c006-6952-4d15-b954-af24867ea048,
  abstract     = {Background— Carotid intima-media thickness (IMT) is increasingly used as a surrogate marker for atherosclerosis. Its use relies on its ability to predict future clinical cardiovascular end points. We performed a systematic review and meta-analysis of data to examine this association.<br/><br>
<br/><br>
Methods and Results— Using a prespecified search strategy, we identified 8 relevant studies and compared study design, measurement protocols, and reported data. We identified sources of heterogeneity between studies. The assumption of a linear relationship between IMT and risk was challenged by use of a graphical technique. To obtain a pooled estimate of the relative risk per IMT difference, we performed a meta-analysis based on random effects models. The age- and sex-adjusted overall estimates of the relative risk of myocardial infarction were 1.26 (95% CI, 1.21 to 1.30) per 1–standard deviation common carotid artery IMT difference and 1.15 (95% CI, 1.12 to 1.17) per 0.10-mm common carotid artery IMT difference. The age- and sex-adjusted relative risks of stroke were 1.32 (95% CI, 1.27 to 1.38) per 1–standard deviation common carotid artery IMT difference and 1.18 (95% CI, 1.16 to 1.21) per 0.10-mm common carotid artery IMT difference. Major sources of heterogeneity were age distribution, carotid segment definition, and IMT measurement protocol. The relationship between IMT and risk was nonlinear, but the linear models fitted relatively well for moderate to high IMT values.<br/><br>
<br/><br>
Conclusions— Carotid IMT is a strong predictor of future vascular events. The relative risk per IMT difference is slightly higher for the end point stroke than for myocardial infarction. In future IMT studies, ultrasound protocols should be aligned with published studies. Data for younger individuals are limited and more studies are required.},
  author       = {Lorenz, Matthias W and Markus, Hugh S and Bots, Michiel L and Rosvall, Maria and Sitzer, Matthias},
  issn         = {1524-4539},
  keyword      = {myocardial infarction,atherosclerosis,meta-analysis,stroke,carotid arteries},
  language     = {eng},
  number       = {4},
  pages        = {459--467},
  publisher    = {Lippincott Williams and Wilkins},
  series       = {Circulation},
  title        = {Prediction of clinical cardiovascular events with carotid intima-media thickness: a systematic review and meta-analysis.},
  url          = {http://dx.doi.org/10.1161/CIRCULATIONAHA.106.628875},
  volume       = {115},
  year         = {2007},
}