Dataset Information

Association of Intima-Media Thickness Measured at the Common Carotid Artery With Incident Carotid Plaque: Individual Participant Data Meta-Analysis of 20 Prospective Studies.

ABSTRACT: Background The association between common carotid artery intima-media thickness (CCA-IMT) and incident carotid plaque has not been characterized fully. We therefore aimed to precisely quantify the relationship between CCA-IMT and carotid plaque development. Methods and Results We undertook an individual participant data meta-analysis of 20 prospective studies from the Proof-ATHERO (Prospective Studies of Atherosclerosis) consortium that recorded baseline CCA-IMT and incident carotid plaque involving 21 494 individuals without a history of cardiovascular disease and without preexisting carotid plaque at baseline. Mean baseline age was 56 years (SD, 9 years), 55% were women, and mean baseline CCA-IMT was 0.71 mm (SD, 0.17 mm). Over a median follow-up of 5.9 years (5th-95th percentile, 1.9-19.0 years), 8278 individuals developed first-ever carotid plaque. We combined study-specific odds ratios (ORs) for incident carotid plaque using random-effects meta-analysis. Baseline CCA-IMT was approximately log-linearly associated with the odds of developing carotid plaque. The age-, sex-, and trial arm-adjusted OR for carotid plaque per SD higher baseline CCA-IMT was 1.40 (95% CI, 1.31-1.50; I²=63.9%). The corresponding OR that was further adjusted for ethnicity, smoking, diabetes, body mass index, systolic blood pressure, low- and high-density lipoprotein cholesterol, and lipid-lowering and antihypertensive medication was 1.34 (95% CI, 1.24-1.45; I²=59.4%; 14 studies; 16 297 participants; 6381 incident plaques). We observed no significant effect modification across clinically relevant subgroups. Sensitivity analysis restricted to studies defining plaque as focal thickening yielded a comparable OR (1.38 [95% CI, 1.29-1.47]; I²=57.1%; 14 studies; 17 352 participants; 6991 incident plaques). Conclusions Our large-scale individual participant data meta-analysis demonstrated that CCA-IMT is associated with the long-term risk of developing first-ever carotid plaque, independent of traditional cardiovascular risk factors.

SUBMITTER: Tschiderer L

PROVIDER: S-EPMC10356054 | biostudies-literature | 2023 Jun

REPOSITORIES: biostudies-literature

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Association of Intima-Media Thickness Measured at the Common Carotid Artery With Incident Carotid Plaque: Individual Participant Data Meta-Analysis of 20 Prospective Studies.

Tschiderer Lena L Seekircher Lisa L Izzo Raffaele R Mancusi Costantino C Manzi Maria V MV Baldassarre Damiano D Amato Mauro M Tremoli Elena E Veglia Fabrizio F Tuomainen Tomi-Pekka TP Kauhanen Jussi J Voutilainen Ari A Iglseder Bernhard B Lind Lars L Rundek Tatjana T Desvarieux Moise M Kato Akihiko A de Groot Eric E Aşçi Gülay G Ok Ercan E Agewall Stefan S Beulens Joline W J JWJ Byrne Christopher D CD Calder Philip C PC Gerstein Hertzel C HC Gresele Paolo P Klingenschmid Gerhard G Nagai Michiaki M Olsen Michael H MH Parraga Grace G Safarova Maya S MS Sattar Naveed N Skilton Michael M Stehouwer Coen D A CDA Uthoff Heiko H van Agtmael Michiel A MA van der Heijden Amber A AA Zozulińska-Ziółkiewicz Dorota A DA Park Hyun-Woong HW Lee Moo-Sik MS Bae Jang-Ho JH Beloqui Oscar O Landecho Manuel F MF Plichart Matthieu M Ducimetiere Pierre P Empana Jean Philippe JP Bokemark Lena L Bergström Göran G Schmidt Caroline C Castelnuovo Samuela S Calabresi Laura L Norata Giuseppe D GD Grigore Liliana L Catapano Alberico A Zhao Dong D Wang Miao M Liu Jing J Ikram M Arfan MA Kavousi Maryam M Bots Michiel L ML Sweeting Michael J MJ Lorenz Matthias W MW Willeit Peter P

Journal of the American Heart Association 20230610 12

Background The association between common carotid artery intima-media thickness (CCA-IMT) and incident carotid plaque has not been characterized fully. We therefore aimed to precisely quantify the relationship between CCA-IMT and carotid plaque development. Methods and Results We undertook an individual participant data meta-analysis of 20 prospective studies from the Proof-ATHERO (Prospective Studies of Atherosclerosis) consortium that recorded baseline CCA-IMT and incident carotid plaque invol ...[more]

PMID: 37301757

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Project description:IntroductionIn the Netherlands, the prevalence of cardiovascular diseases (CVDs) is higher among South-Asian Surinamese and lower among Moroccans compared to the Dutch. Traditional risk factors for atherosclerotic CVD do not fully explain these disparities. We aimed to assess ethnic differences in plaque presence and carotid intima-media thickness (cIMT) and explore to what extent these differences are explained by traditional risk factors.MethodsWe used cross-sectional data from a subgroup of participants enrolled in the multi-ethnic population-based Healthy Life in an Urban Setting (HELIUS) study who underwent carotid ultrasonography. Logistic and linear regression models were built to assess ethnic differences in plaque presence and cIMT with the Dutch population as reference. Additional models were created to adjust for socioeconomic status, body height, and cardiovascular risk factors.ResultsOf the 3,022 participants, 1,183, 1,051, and 790 individuals were of Dutch, South-Asian Surinamese, and Moroccan descent, respectively. Mean age was 60.9 years (SD: 8.0), and 52.8% were female. Compared to the Dutch, we found lower odds for plaque presence in Moroccans (0.77, 95% CI: 0.62; 0.95) and no significant differences between the South-Asian Surinamese and Dutch population (0.91, 95% CI: 0.76; 1.10). After adjustment for CVD risk factors, we found a lower plaque presence in South-Asian Surinamese (0.63, 95% CI: 0.48; 0.82). In both Moroccan and South-Asian Surinamese individuals, adjustment for socioeconomic status did not materially change the results. cIMT was lower in South-Asian Surinamese compared to the Dutch (-17.9 μm, 95% CI: -27.9; -7.9) and partly explained by ethnic differences in the body height as South-Asian Surinamese individuals were, on average, shorter than the Dutch population. No differences in cIMT between Moroccans and Dutch were found.ConclusionscIMT and plaque prevalence differ between ethnic groups independent of CVD risk. Lower plaque prevalence in Moroccans was partly attributable to a lower prevalence of traditional CVD risk factors, while body height was an important contributor to differences in cIMT in South Asians. This study emphasizes the need for ethnic-specific cut-off values for plaque presence and cIMT.

Project description:Background and objectivesCarotid intima-media thickness has been reported to predict kidney function decline. However, whether carotid intima-media thickness is associated with a hard kidney end point, ESRD, has not been investigated.Design, setting, participants, & measurementsWe studied 13,197 Atherosclerosis Risk in Communities participants at visit 1 (1987-1989) without history of cardiovascular disease, including coronary heart disease, stroke, and heart failure, at baseline and assessed whether carotid intima-media thickness measured by B-mode ultrasound is associated with ESRD risk using Cox proportional hazards models. Regarding carotid intima-media thickness parameters, we investigated the mean and maximum values of overall and segment-specific (common, bifurcation, and internal carotid arteries) measurements.ResultsMean age was 54.0 (SD=5.7) years old, and there were 3373 (25.6%) blacks and 7370 (55.8%) women. During a median follow-up of 22.7 years, 433 participants developed ESRD (1.4/1000 person-years). After adjusting for shared risk factors for atherosclerosis and kidney disease, including baseline kidney function, carotid intima-media thickness was significantly associated with ESRD risk (hazard ratio [HR] between quartiles 4 and 1, 1.46; 95% confidence interval [95% CI], 1.02 to 2.08 for overall mean intima-media thickness and HR between quartiles 4 and 1, 1.75; 95% CI, 1.24 to 2.48 for overall maximum intima-media thickness). The associations were largely consistent in demographic and clinical subgroups. When we explored segment-specific intima-media thicknesses, the associations with ESRD were most robust for bifurcation carotid (e.g., adjusted HR between quartiles 4 and 1 of mean intima-media thickness, 1.49; 95% CI, 1.04 to 2.13 for bifurcation; adjusted HR between quartiles 4 and 1 of mean intima-media thickness, 1.36; 95% CI, 0.94 to 1.97 for common; and adjusted HR between quartiles 4 and 1 of mean intima-media thickness, 0.93; 95% CI, 0.67 to 1.29 for internal).ConclusionsCarotid intima-media thickness was independently associated with incident ESRD in the general population, suggesting the shared etiology of atherosclerosis and ESRD.

Dataset Information

Association of Intima-Media Thickness Measured at the Common Carotid Artery With Incident Carotid Plaque: Individual Participant Data Meta-Analysis of 20 Prospective Studies.

Publications

Association of Intima-Media Thickness Measured at the Common Carotid Artery With Incident Carotid Plaque: Individual Participant Data Meta-Analysis of 20 Prospective Studies.

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