Carotid intima–media thickness: ultrasound measurement, prognostic value and role in clinical practice

Abstract

Ultrasound measurement of carotid intima-media thickness (IMT) has become a valuable tool for detecting and monitoring progression of atherosclerosis and recently published recommendations provide guidance for proper standardisation of these measurements. Important determinants of carotid IMT include age, gender, systolic blood pressure, diabetes mellitus and serum cholesterol levels. Many studies have shown carotid IMT to correlate with the severity of coronary atherosclerosis assessed by CT coronary calcification scores, coronary angiography and intravascular ultrasound. Consistent with its correlation with cardiovascular risk factors and coronary artery disease, a meta-analysis of large observational studies has shown carotid IMT to be a strong predictor of future cardiovascular events. Moreover, in patients with established coronary artery disease a reduction in carotid IMT has been shown to translate into a reduction in future cardiovascular events. Consensus statements now also recommend carotid IMT measurements to further refine the prognostic assessment of patients traditionally considered to be at an intermediate risk of cardiovascular disease.

Circulating annexin A5 levels are associated with carotid intima-media thickness but not coronary plaque composition

“…10 We extend the current knowledge by demonstrating a positive relationship between anxA5 plasma levels and carotid IMT, a surrogate marker of systemic atherosclerosis, in high-risk patients with type 2 diabetes and stable coronary artery disease. 15 We could also show that anxA5 is associated with IMT thickening even when adjusted for multiple other cardiovascular risk factors including male gender, age, smoking, hypertension, Hb A1C levels, waist circumference, BMI, total cholesterol, LDL-cholesterol and CRP levels. These data suggest that anxA5 is a robust predictor for IMT thickening and independent from classical cardiovascular risk factors and biomarkers.…”

“…14,15 Given that atherosclerosis is a systemic process, the carotids are the arteries of choice to non-invasively image IMT as a surrogate parameter for systemic atherosclerosis, 15 and recently, carotid IMT has even been associated with cardiovascular events. 14 Optical coherence tomography (OCT) is a novel intravascular imaging modality with a resolution 10-fold higher than intravascular ultrasound.…”

The Value of Subclinical Carotid Atherosclerosis for Primary Prevention of Cardiovascular Diseases. Review of the Main International Studies

“…По их данным добавление информации о величине ТКИМ к традиционным факторам риска (ФР) не при-водила к изменению оценки кардиоваскулярного рис-ка, а при прогнозировании КБС значение ТКИМ усту-пало АСБ в качестве предиктора [13]. Тем не менее, в ряде работ все же предлагается использовать измере-ние ТКИМ в качестве дополнительной информации для стратификации риска пациента в индивидуальных случаях [14]. В 2007 г. был опубликован мета-анализ 8 крупных проспективных исследований, показав-ший, что увеличение ТКИМ на 0,1 мм сопровождает-ся увеличением риска развития ИМ на 10-15%, а риска инсульта -на 13-18%, с учетом пола и возрас-та, однако эта зависимость носила нелинейный характер [15].…”

Carotid Artery Intimal-Medial Thickness and Left Ventricular Longitudinal Systolic Strain in Patients with Coronary Artery Disease

“…Ultrasound measurement of carotid intima-media thickness (CIMT) has become a valuable tool for detecting and monitoring progression of atherosclerosis [2]. The American College of Cardiology Foundation/American Heart Association guidelines recommend CIMT measurements for patients at intermediate CVD risk [3].…”

“…Coronary angiography (CA) is currently considered the gold standard for detecting obstructive coronary artery disease. However, its inability to detect early atherosclerotic changes, its invasive nature, as well as exposure to ionizing radiation, make it an unattractive primary screening tool in preventive cardiology [2].…”