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Intima-media thickness

A tool for atherosclerosis imaging and event prediction

      Abstract

      Multiple studies have shown that the carotid artery intima-media thickness (IMT), as measured noninvasively by ultrasonography, is directly associated with an increased risk of cardiovascular disease. Because it has been shown to be an independent predictor of cardiovascular disease after adjustment for traditional risk factors, it is the only noninvasive imaging test currently recommended by the American Heart Association for inclusion in the evaluation of risk. However, it remains unclear how much additional information beyond that afforded by traditional risk factors is gained by inclusion of IMT in risk profiles. Change in IMT is increasingly being used as the end point in interventional trials. Meaningful differences in progression rates have been shown in progression rates in trials of either lipid-lowering drugs or calcium channel blockers involving several hundred subjects over a period of several years. Acceptance of a standardized protocol for measuring IMT change would facilitate comparison of results from the many trials using this technique. However, uncertainty about which measure of IMT offers the best end point has inhibited methodologic standardization.
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      References

        • Smith Jr, S.C.
        • Greenland P.
        • Grundy S.M.
        Prevention conference V.
        Circulation. 2000; 101: 111-116
        • Kannel W.B.
        • McGee D.
        • Gordon T.
        A general cardiovascular risk profile.
        Am J Cardiol. 1976; 38: 46-51
        • Pearson T.A.
        New tools for coronary risk assessment.
        Circulation. 2002; 105: 886-892
        • Pignoli P.
        • Tremoli E.
        • Poli A.
        • Oreste P.
        • Paoletti R.
        Intimal plus medial thickness of the arterial wall.
        Circulation. 1986; 74: 1399-1406
        • O’Leary D.H.
        • Polak J.F.
        • Kronmal J.F.
        • Savage P.J.
        • Borhani N.O.
        • Kittner S.J.
        • Tracy R.
        • Gardin J.M.
        • Price T.R.
        • Furberg C.D.
        Thickening of the carotid wall.
        Stroke. 1996; 27: 224-231
        • Kuller L.H.
        • Shemanski L.
        • Psaty B.M.
        • Borhani N.O.
        • Gardin J.
        • Haan M.
        • O’Leary D.H.
        • Savage P.J.
        • Tell G.S.
        • Tracy R.
        Subclinical disease as an independent risk factor for cardiovascular disease.
        Circulation. 1995; 92: 720-726
        • Bots M.L.
        • Hoes A.W.
        • Koudstaal P.J.
        • Hofman A.
        • Grobbee D.E.
        Common carotid artery intima-media thickness and risk of stroke and myocardial infarction.
        Circulation. 1997; 96: 1432-1437
        • Chambless L.E.
        • Heiss G.
        • Folsom A.R.
        • Rosamond W.
        • Szklo M.
        • Sharrett A.R.
        • Clegg L.X.
        Association of coronary heart disease incidence with carotid arterial wall thickness and major risk factors.
        Am J Epidemiol. 1997; 146: 483-494
        • Hodis H.N.
        • Mack W.J.
        • LaBree L.
        • Selzer H.
        • Liu C.
        • Azen S.P.
        The role of carotid arterial intima-media thickness in predicting clinical coronary events.
        Ann Intern Med. 1998; 128: 262-269
        • O’Leary D.H.
        • Polak J.F.
        • Kronmal R.A.
        • Manolio T.A.
        • Burke G.L.
        • Wolfson Jr, S.K.
        Carotid-artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults. Cardiovascular Health Study.
        N Engl J Med. 1999; 340: 14-22
        • del Sol A.I.
        • Moons K.G.M.
        • Hollander M.
        • Hofman A.
        • Koudstaal P.J.
        • Grobbee D.E.
        • Breteler M.M.B.
        • Witteman J.C.M.
        • Bots M.L.
        Is carotid intima-mendia thickness useful in cardiovascular disease risk assessment? The Rotterdam Study.
        Stroke. 2001; 32: 1532-1538
        • Blankenhorn D.H.
        • Seltzer R.H.
        • Crawford D.W.
        • Barth J.D.
        • Liu C.R.
        • Liu C.H.
        • Mack W.J.
        • Alaupovic P.
        Beneficial effects of colestipol-niacin therapy on carotid atherosclerosis.
        Circulation. 1993; 88: 20-28
        • Furberg C.D.
        • Adams H.P.
        • Applegate W.B.
        • Byington R.P.
        • Espeland M.A.
        • Hartwell T.
        • Hunninghake D.B.
        • Lefkowitz D.S.
        • Probstfield J.
        • Riley W.A.
        • Young B.
        • Asymptomatic Carotid Artery Progression Study (ACAPS) Research Group
        Effect of lovastatin on early carotid atherosclerosis and cardiovascular events.
        Circulation. 1994; 90: 1679-1687
        • Smilde T.J.
        • Wissen S.V.
        • Wollersheim H.
        • Trip M.
        • Kastelein J.J.P.
        • Stalenhoef A.F.H.
        Effect of aggressive versus conventional lipid lowering on atherosclerosis progression in familial hypercholesterolaemia (ASAP).
        Lancet. 2001; 357: 577-581
        • Wiklund O.
        • Hulthe J.
        • Wikstrand J.
        • Schmidt C.
        • Olofsson S.V.
        • Bondjers G.
        Effect of controlled release/extended release metoprolol on carotid intima-media thickness in patients with hypercholesterolemia.
        Stroke. 2002; 33: 572-577
        • O’Leary D.H.
        • Polak J.F.
        • Kronmal J.F.
        • Savage P.J.
        • Borhani N.O.
        • Kittner S.J.
        • Tracy R.
        • Gardin J.M.
        • Price T.R.
        • Furberg C.D.
        Thickening of the carotid wall.
        Stroke. 1996; 27: 224-231