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Common Carotid Intima-Media Thickness Measurements in Cardiovascular Risk Prediction A Meta-analysis

Den Ruijter, Hester M.; Peters, Sanne A. E.; Anderson, Todd J.; Britton, Annie R.; Dekker, Jacqueline M.; Eijkemans, Marinus J.; Engström, Gunnar LU ; Evans, Gregory W.; de Graaf, Jacqueline and Grobbee, Diederick E., et al. (2012) In JAMA: the journal of the American Medical Association 308(8). p.796-803
Abstract
Context The evidence that measurement of the common carotid intima-media thickness (CIMT) improves the risk scores in prediction of the absolute risk of cardiovascular events is inconsistent. Objective To determine whether common CIMT has added value in 10-year risk prediction of first-time myocardial infarctions or strokes, above that of the Framingham Risk Score. Data Sources Relevant studies were identified through literature searches of databases (PubMed from 1950 to June 2012 and EMBASE from 1980 to June 2012) and expert opinion. Study Selection Studies were included if participants were drawn from the general population, common CIMT was measured at baseline, and individuals were followed up for first-time myocardial infarction or... (More)
Context The evidence that measurement of the common carotid intima-media thickness (CIMT) improves the risk scores in prediction of the absolute risk of cardiovascular events is inconsistent. Objective To determine whether common CIMT has added value in 10-year risk prediction of first-time myocardial infarctions or strokes, above that of the Framingham Risk Score. Data Sources Relevant studies were identified through literature searches of databases (PubMed from 1950 to June 2012 and EMBASE from 1980 to June 2012) and expert opinion. Study Selection Studies were included if participants were drawn from the general population, common CIMT was measured at baseline, and individuals were followed up for first-time myocardial infarction or stroke. Data Extraction Individual data were combined into 1 data set and an individual participant data meta-analysis was performed on individuals without existing cardiovascular disease. Results We included 14 population-based cohorts contributing data for 45 828 individuals. During a median follow-up of 11 years, 4007 first-time myocardial infarctions or strokes occurred. We first refitted the risk factors of the Framingham Risk Score and then extended the model with common CIMT measurements to estimate the absolute 10-year risks to develop a first-time myocardial infarction or stroke in both models. The C statistic of both models was similar (0.757; 95% CI, 0.749-0.764; and 0.759; 95% CI, 0.752-0.766). The net reclassification improvement with the addition of common CIMT was small (0.8%; 95% CI, 0.1%-1.6%). In those at intermediate risk, the net reclassification improvement was 3.6% in all individuals (95% CI, 2.7%-4.6%) and no differences between men and women. Conclusion The addition of common CIMT measurements to the Framingham Risk Score was associated with small improvement in 10-year risk prediction of first-time myocardial infarction or stroke, but this improvement is unlikely to be of clinical importance. JAMA. 2012;308(8):796-803 www.jama.com (Less)
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JAMA: the journal of the American Medical Association
volume
308
issue
8
pages
796 - 803
publisher
American Medical Association
external identifiers
  • wos:000307705300023
  • scopus:84865312335
ISSN
1538-3598
DOI
10.1001/jama.2012.9630
language
English
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yes
id
5e085cec-27f8-4a94-8d63-bc3b96e7ad0b (old id 3070091)
date added to LUP
2012-10-05 07:10:57
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2017-11-12 03:41:56
@article{5e085cec-27f8-4a94-8d63-bc3b96e7ad0b,
  abstract     = {Context The evidence that measurement of the common carotid intima-media thickness (CIMT) improves the risk scores in prediction of the absolute risk of cardiovascular events is inconsistent. Objective To determine whether common CIMT has added value in 10-year risk prediction of first-time myocardial infarctions or strokes, above that of the Framingham Risk Score. Data Sources Relevant studies were identified through literature searches of databases (PubMed from 1950 to June 2012 and EMBASE from 1980 to June 2012) and expert opinion. Study Selection Studies were included if participants were drawn from the general population, common CIMT was measured at baseline, and individuals were followed up for first-time myocardial infarction or stroke. Data Extraction Individual data were combined into 1 data set and an individual participant data meta-analysis was performed on individuals without existing cardiovascular disease. Results We included 14 population-based cohorts contributing data for 45 828 individuals. During a median follow-up of 11 years, 4007 first-time myocardial infarctions or strokes occurred. We first refitted the risk factors of the Framingham Risk Score and then extended the model with common CIMT measurements to estimate the absolute 10-year risks to develop a first-time myocardial infarction or stroke in both models. The C statistic of both models was similar (0.757; 95% CI, 0.749-0.764; and 0.759; 95% CI, 0.752-0.766). The net reclassification improvement with the addition of common CIMT was small (0.8%; 95% CI, 0.1%-1.6%). In those at intermediate risk, the net reclassification improvement was 3.6% in all individuals (95% CI, 2.7%-4.6%) and no differences between men and women. Conclusion The addition of common CIMT measurements to the Framingham Risk Score was associated with small improvement in 10-year risk prediction of first-time myocardial infarction or stroke, but this improvement is unlikely to be of clinical importance. JAMA. 2012;308(8):796-803 www.jama.com},
  author       = {Den Ruijter, Hester M. and Peters, Sanne A. E. and Anderson, Todd J. and Britton, Annie R. and Dekker, Jacqueline M. and Eijkemans, Marinus J. and Engström, Gunnar and Evans, Gregory W. and de Graaf, Jacqueline and Grobbee, Diederick E. and Hedblad, Bo and Hofman, Albert and Holewijn, Suzanne and Ikeda, Ai and Kavousi, Maryam and Kitagawa, Kazuo and Kitamura, Akihiko and Koffijberg, Hendrik and Lonn, Eva M. and Lorenz, Matthias W. and Mathiesen, Ellisiv B. and Nijpels, Giel and Okazaki, Shuhei and O'Leary, Daniel H. and Polak, Joseph F. and Price, Jackie F. and Robertson, Christine and Rembold, Christopher M. and Rosvall, Maria and Rundek, Tatjana and Salonen, Jukka T. and Sitzer, Matthias and Stehouwer, Coen D. A. and Witteman, Jacqueline C. and Moons, Karel G. and Bots, Michiel L.},
  issn         = {1538-3598},
  language     = {eng},
  number       = {8},
  pages        = {796--803},
  publisher    = {American Medical Association},
  series       = {JAMA: the journal of the American Medical Association},
  title        = {Common Carotid Intima-Media Thickness Measurements in Cardiovascular Risk Prediction A Meta-analysis},
  url          = {http://dx.doi.org/10.1001/jama.2012.9630},
  volume       = {308},
  year         = {2012},
}