Intima-media thickness at the near or far wall of the common carotid artery in cardiovascular risk assessment

Lisa Seekircher; Lena Tschiderer; Lars Lind; Maya S. Safarova; Maryam Kavousi; M. Arfan Ikram; Eva Lonn; Salim Yusuf; Diederick E. Grobbee; John J.P. Kastelein; Frank L.J. Visseren; Matthew Walters; Jesse Dawson; Peter Higgins; Stefan Agewall; Alberico Catapano; Eric De Groot; Mark A. Espeland; Gerhard Klingenschmid; Dianna Magliano; Michael H. Olsen; David Preiss; Dirk Sander; Michael Skilton; Dorota A. Zozulińska-Ziółkiewicz; Muriel P.C. Grooteman; Peter J. Blankestijn; Kazuo Kitagawa; Shuhei Okazaki; Maria V. Manzi; Costantino Mancusi; Raffaele Izzo; Moise Desvarieux; Tatjana Rundek; Hertzel C. Gerstein; Michiel L. Bots; Michael J. Sweeting; Matthias W. Lorenz; Peter Willeit

doi:10.1093/ehjopen/oead089

Intima-media thickness at the near or far wall of the common carotid artery in cardiovascular risk assessment

Lisa Seekircher, Lena Tschiderer, Lars Lind, Maya S. Safarova, Maryam Kavousi, M. Arfan Ikram, Eva Lonn, Salim Yusuf, Diederick E. Grobbee, John J.P. Kastelein, Frank L.J. Visseren, Matthew Walters, Jesse Dawson, Peter Higgins, Stefan Agewall, Alberico Catapano, Eric De Groot, Mark A. Espeland, Gerhard Klingenschmid, Dianna MaglianoMichael H. Olsen, David Preiss, Dirk Sander, Michael Skilton, Dorota A. Zozulińska-Ziółkiewicz, Muriel P.C. Grooteman, Peter J. Blankestijn, Kazuo Kitagawa, Shuhei Okazaki, Maria V. Manzi, Costantino Mancusi, Raffaele Izzo, Moise Desvarieux, Tatjana Rundek, Hertzel C. Gerstein, Michiel L. Bots, Michael J. Sweeting, Matthias W. Lorenz, Peter Willeit^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

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.

Original language	English
Article number	oead089
Journal	European heart journal open
Volume	3
Issue number	5
DOIs	https://doi.org/10.1093/ehjopen/oead089
Publication status	Published - 1 Sept 2023

Keywords

Cardiovascular risk
Common carotid artery intima-media thickness
Individual-participant-data meta-analysis

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10.1093/ehjopen/oead089Licence: CC BY-NC

oead089Final published version, 853 KBLicence: CC BY-NC

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Seekircher, L., Tschiderer, L., Lind, L., Safarova, M. S., Kavousi, M., Ikram, M. A., Lonn, E., Yusuf, S., Grobbee, D. E., Kastelein, J. J. P., Visseren, F. L. J., Walters, M., Dawson, J., Higgins, P., Agewall, S., Catapano, A., De Groot, E., Espeland, M. A., Klingenschmid, G., ... Willeit, P. (2023). Intima-media thickness at the near or far wall of the common carotid artery in cardiovascular risk assessment. European heart journal open, 3(5), Article oead089. https://doi.org/10.1093/ehjopen/oead089

@article{62da78cb8ca24e938b532a9ae7f4d683,

title = "Intima-media thickness at the near or far wall of the common carotid artery in cardiovascular risk assessment",

abstract = "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.",

keywords = "Cardiovascular risk, Common carotid artery intima-media thickness, Individual-participant-data meta-analysis",

author = "Lisa Seekircher and Lena Tschiderer and Lars Lind and Safarova, {Maya S.} and Maryam Kavousi and Ikram, {M. Arfan} and Eva Lonn and Salim Yusuf and Grobbee, {Diederick E.} and Kastelein, {John J.P.} and Visseren, {Frank L.J.} and Matthew Walters and Jesse Dawson and Peter Higgins and Stefan Agewall and Alberico Catapano and {De Groot}, Eric and Espeland, {Mark A.} and Gerhard Klingenschmid and Dianna Magliano and Olsen, {Michael H.} and David Preiss and Dirk Sander and Michael Skilton and Zozuli{\'n}ska-Zi{\'o}{\l}kiewicz, {Dorota A.} and Grooteman, {Muriel P.C.} and Blankestijn, {Peter J.} and Kazuo Kitagawa and Shuhei Okazaki and Manzi, {Maria V.} and Costantino Mancusi and Raffaele Izzo and Moise Desvarieux and Tatjana Rundek and Gerstein, {Hertzel C.} and Bots, {Michiel L.} and Sweeting, {Michael J.} and Lorenz, {Matthias W.} and Peter Willeit",

note = "Publisher Copyright: {\textcopyright} 2023 The Author(s). Published by Oxford University Press on behalf of the European Society of Cardiology.",

year = "2023",

month = sep,

day = "1",

doi = "10.1093/ehjopen/oead089",

language = "English",

volume = "3",

number = "5",

}

Seekircher, L, Tschiderer, L, Lind, L, Safarova, MS, Kavousi, M, Ikram, MA, Lonn, E, Yusuf, S, Grobbee, DE, Kastelein, JJP, Visseren, FLJ, Walters, M, Dawson, J, Higgins, P, Agewall, S, Catapano, A, De Groot, E, Espeland, MA, Klingenschmid, G, Magliano, D, Olsen, MH, Preiss, D, Sander, D, Skilton, M, Zozulińska-Ziółkiewicz, DA, Grooteman, MPC, Blankestijn, PJ, Kitagawa, K, Okazaki, S, Manzi, MV, Mancusi, C, Izzo, R, Desvarieux, M, Rundek, T, Gerstein, HC, Bots, ML, Sweeting, MJ, Lorenz, MW & Willeit, P 2023, 'Intima-media thickness at the near or far wall of the common carotid artery in cardiovascular risk assessment', European heart journal open, vol. 3, no. 5, oead089. https://doi.org/10.1093/ehjopen/oead089

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

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 - 10.1093/ehjopen/oead089

DO - 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 -

Intima-media thickness at the near or far wall of the common carotid artery in cardiovascular risk assessment

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