Scientific 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. Scientific Publication
Lena Tschiderer 1 , Lisa Seekircher 1 , Raffaele Izzo 2 , Costantino Mancusi 2 , Maria V Manzi 2 , Damiano Baldassarre 3 4 , Mauro Amato 4 , Elena Tremoli 5 , Fabrizio Veglia 5 , Tomi-Pekka Tuomainen 6 , Jussi Kauhanen 6 , Ari Voutilainen 6 , Bernhard Iglseder 7 8 , Lars Lind 9 , Tatjana Rundek 10 , Moise Desvarieux 11 12 , Akihiko Kato 13 , Eric de Groot 14 15 , Gülay Aşçi 16 , Ercan Ok 16 , Stefan Agewall 17 18 , Joline W J Beulens 19 , Christopher D Byrne 20 21 , Philip C Calder 20 21 , Hertzel C Gerstein 22 23 , Paolo Gresele 24 , Gerhard Klingenschmid 25 , Michiaki Nagai 26 , Michael H Olsen 27 , Grace Parraga 28 , Maya S Safarova 29 , Naveed Sattar 30 , Michael Skilton 31 , Coen D A Stehouwer 32 , Heiko Uthoff 33 , Michiel A van Agtmael 34 , Amber A van der Heijden 35 , Dorota A Zozulińska-Ziółkiewicz 36 , Hyun-Woong Park 37 , Moo-Sik Lee 38 39 , Jang-Ho Bae 40 41 , Oscar Beloqui 42 , Manuel F Landecho 42 , Matthieu Plichart 43 44 , Pierre Ducimetiere 45 , Jean Philippe Empana 43 , Lena Bokemark 46 , Göran Bergström 47 48 , Caroline Schmidt 46 , Samuela Castelnuovo 49 , Laura Calabresi 50 , Giuseppe D Norata 50 51 , Liliana Grigore 52 , Alberico Catapano 50 52 , Dong Zhao 53 , Miao Wang 53 , Jing Liu 53 , M Arfan Ikram 54 , Maryam Kavousi 54 , Michiel L Bots 55 , Michael J Sweeting 56 57 , Matthias W Lorenz 58 59 , Peter Willeit 1 57 ; Proof‐ATHERO Study Group
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.
CITATION J Am Heart Assoc. 2023 Jun 20;12(12):e027657. doi: 10.1161/JAHA.122.027657. Epub 2023 Jun 10.
