Lessons From the Past and Promises for the Future for Carotid Intima-Media Thickness

Abstract

Carotid intima-media thickness (CIMT) measurements have been used in cardiovascular research for more than 2 decades. There is a wealth of evidence showing that CIMT can be assessed in a reproducible manner and that increased CIMT relates to unfavorable risk factor levels and atherosclerosis elsewhere in the arterial system and to the risk of vascular events. Change in CIMT over time can be readily assessed, and trials showed that the rate of change is modifiable by treatment. Several issues important for the cardiovascular research community and its application in clinical practice are still outstanding. Promising future areas for CIMT measurements are: 1) application in studies among children and adolescents; 2) use of CIMT trials positioned decisively before the start of a morbidity and mortality trial; and 3) the use of CIMT measurement in risk stratification in those with an intermediate 10-year risk estimate.

Long-term health benefits and costs of measurement of carotid intima–media thickness in prevention of coronary heart disease

“…Before CIMT measurements can be implemented on a large scale, several issues must be addressed [34]. Populationbased normative data for CIMT and presence of carotid plaque are needed.…”

Carotid ultrasonography in the assessment of cardiovascular risk

“…Although it is without doubt that the development of carotid and coronary plaques is closely related [68], the transition from a population level to an individual patient management in terms of cardiovascular prevention remains not unanimously stated, since in the individual subject the presence of a carotid plaque does not automatically imply the presence of an underlying coronary artery disease and hence the need to perform a coronary angiography [69].…”

Human Genetic Evidence for Involvement of CD137 in Atherosclerosis

“…Although the net effects of CD137 stimulation in development of human atherosclerotic disease are currently unknown, it is tempting to speculate that the minor T allele of rs2453021 is associated with a more unfavorable T EFF / T REG activity balance, which would promote inflammation and aggravate atherosclerosis in the carotid arteries. Furthermore, in humans, the CD4 + CD28 null T-cell population, an aberrant subpopulation that lacks the key costimulatory molecule CD28, expands with age and is increased in patients with ACS compared with patients with stable angina or controls (13 (39). Carotid IMT, as measured by highresolution ultrasound, is a widely used marker of subclinical atherosclerosis.…”