Dataset Information

Relation of Carotid Intima-Media Thickness to Cardiovascular Events in Black Americans (From the Jackson Heart Study).

ABSTRACT: Although several prospective studies have reported independent relations between carotid intima-media thickness (CIMT) and risk of incident cardiovascular diseases (CVD) in primarily non-African-American (AA) cohorts, the utility of CIMT values for the prediction of incident coronary heart disease and stroke events in blacks remain unclear. At the baseline examination (2000 to 2004) of the Jackson Heart Study, AA adults 21 to 94 years of age (mean 54) underwent bilateral far-wall CIMT measurement (mean 0.76?mm). Incident CVD events were then assessed over 7 to 11 years of follow-up (2000 to 2011) from samples of 2,463 women (107 CVD events) and 1,338 men (64 CVD events) who were free of clinical CVD at baseline. Each 0.2-mm increase in CIMT was associated with age-adjusted incident CVD hazard ratios of 1.4 (95% confidence interval 1.2, 1.5) for women and 1.3 (1.1, 1.6) for men. Classification accuracy improved only slightly when comparing multivariable models that used traditional risk factors alone with models that added CIMT: C-statistics 0.837 (0.794, 0.881) versus 0.842 (0.798, 0.886) in women and 0.754 (0.683, 0.826) versus 0.763 (0.701, 0.825) in men. Similarly, risk reclassification was only mildly improved by adding CIMT: Net Reclassification Index 0.13 (p?=?0.05) and 0.05 (p?=?0.50) for women and men, respectively; Integrated Discrimination Improvement 0.02 (p?=?0.02) and 0.01 (p?=?0.26) for women and men, respectively. In conclusion, CIMT was associated with incident CVD but provided modest incremental improvement in risk reclassification beyond traditional risk factors in a community-based AA cohort.

SUBMITTER: Villines TC

PROVIDER: S-EPMC5640488 | biostudies-literature | 2017 Nov

REPOSITORIES: biostudies-literature

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Relation of Carotid Intima-Media Thickness to Cardiovascular Events in Black Americans (From the Jackson Heart Study).

Villines Todd C TC Hsu Lucy L LL Blackshear Chad C Nelson Cheryl R CR Griswold Michael M

The American journal of cardiology 20170731 9

Although several prospective studies have reported independent relations between carotid intima-media thickness (CIMT) and risk of incident cardiovascular diseases (CVD) in primarily non-African-American (AA) cohorts, the utility of CIMT values for the prediction of incident coronary heart disease and stroke events in blacks remain unclear. At the baseline examination (2000 to 2004) of the Jackson Heart Study, AA adults 21 to 94 years of age (mean 54) underwent bilateral far-wall CIMT measuremen ...[more]

PMID: 28844515

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Project description:BackgroundIntima-media thickness of the walls of the common carotid artery and internal carotid artery may add to the Framingham risk score for predicting cardiovascular events.MethodsWe measured the mean intima-media thickness of the common carotid artery and the maximum intima-media thickness of the internal carotid artery in 2965 members of the Framingham Offspring Study cohort. Cardiovascular-disease outcomes were evaluated for an average follow-up of 7.2 years. Multivariable Cox proportional-hazards models were generated for intima-media thickness and risk factors. We evaluated the reclassification of cardiovascular disease on the basis of the 8-year Framingham risk score category (low, intermediate, or high) after adding intima-media thickness values.ResultsA total of 296 participants had a cardiovascular event. The risk factors of the Framingham risk score predicted these events, with a C statistic of 0.748 (95% confidence interval [CI], 0.719 to 0.776). The adjusted hazard ratio for cardiovascular disease with a 1-SD increase in the mean intima-media thickness of the common carotid artery was 1.13 (95% CI, 1.02 to 1.24), with a nonsignificant change in the C statistic of 0.003 (95% CI, 0.000 to 0.007); the corresponding hazard ratio for the maximum intima-media thickness of the internal carotid artery was 1.21 (95% CI, 1.13 to 1.29), with a modest increase in the C statistic of 0.009 (95% CI, 0.003 to 0.016). The net reclassification index increased significantly after addition of intima-media thickness of the internal carotid artery (7.6%, P<0.001) but not intima-media thickness of the common carotid artery (0.0%, P=0.99). With the presence of plaque, defined as intima-media thickness of the internal carotid artery of more than 1.5 mm, the net reclassification index was 7.3% (P=0.01), with an increase in the C statistic of 0.014 (95% CI, 0.003 to 0.025).ConclusionsThe maximum internal and mean common carotid-artery intima-media thicknesses both predict cardiovascular outcomes, but only the maximum intima-media thickness of (and presence of plaque in) the internal carotid artery significantly (albeit modestly) improves the classification of risk of cardiovascular disease in the Framingham Offspring Study cohort. (Funded by the National Heart, Lung, and Blood Institute.).

Dataset Information

Relation of Carotid Intima-Media Thickness to Cardiovascular Events in Black Americans (From the Jackson Heart Study).

Publications

Relation of Carotid Intima-Media Thickness to Cardiovascular Events in Black Americans (From the Jackson Heart Study).

Similar Datasets

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