Prediction of Clinical Cardiovascular Events With Carotid Intima-Media Thickness

Lorenz, Matthias; Markus, Hugh S.; Bots, Michiel L.; Rosvall, Maria; Sitzer, Matthias

doi:10.1161/circulationaha.106.628875

Cited by 2,712 publications

(2,026 citation statements)

References 25 publications

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“…However, since the number of end points is crucial for prospective studies, the number of participants was prioritized during the screening examination. The relationship with incidence of stroke is largely the same in this cohort, compared with studies with ultrasound assessment of both carotid arteries 29. Carotid plaque was defined as an intima–media thickness protrusion of at least 1.2 mm, which is somewhat less than the definition that later was proposed by the Mannheim consensus group (ie, ≥1.5 mm) 30…”

Section: Discussionmentioning

confidence: 77%

Cadmium, Carotid Atherosclerosis, and Incidence of Ischemic Stroke

Borné

Fagerberg

Persson

et al. 2017

JAHA

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BackgroundExposure to cadmium has been associated with carotid plaques, inflammation in carotid plaques, and increased risk of ischemic stroke. This study examined the separate and interacting effects of blood cadmium levels and carotid plaques on the risk of incident ischemic stroke.Methods and ResultsCadmium levels were measured in 4156 subjects (39.2% men; mean±SD age 57.3±5.9 years) without history of stroke, from the Malmö Diet and Cancer cohort. The right carotid artery was examined using B‐mode ultrasound examination at baseline. Incidence of ischemic stroke was monitored over a mean follow‐up of 16.7 years. Carotid plaque was present in 34.5% of participants. Cadmium was significantly higher in subjects with plaque (mean±SD: 0.53±0.58 μg/L versus 0.42±0.49 μg/L; P<0.001). A total of 221 subjects had ischemic stroke during the follow‐up. Incidence of ischemic stroke was associated both with carotid plaque (hazard ratio 1.44, 95% confidence interval, 1.09–1.90, P=0.009) and cadmium (hazard ratio for quartile [Q] 4 versus Q1–3: 1.95, confidence interval, 1.33–2.85, P=0.001), after adjustment for risk factors. There was a significant interaction between cadmium and plaque with respect to risk of ischemic stroke (P=0.011). Adjusted for risk factors, subjects with plaque and cadmium in Q4 had a hazard ratio of 2.88 (confidence interval, 1.79–4.63) for ischemic stroke, compared with those without plaque and cadmium in Q1 to Q3.ConclusionsCadmium was associated with incidence of ischemic stroke, both independently and in synergistic interaction with carotid plaques. This supports the hypothesis that cadmium promotes vulnerability of carotid plaques, thereby increasing the risk of rupture and ischemic stroke.

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Section: Discussionmentioning

confidence: 77%

Cadmium, Carotid Atherosclerosis, and Incidence of Ischemic Stroke

Borné

Fagerberg

Persson

et al. 2017

JAHA

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“…The underlying cause of these cardiovascular disease subgroups is atherosclerosis, a complex multifactorial disorder of the arteries initiated by endothelial dysfunction, inflammation, and dyslipidemia 2, 3. Subclinical measures of atherosclerosis include common carotid artery intima‐media thickness (CCA‐IMT) and carotid atherosclerotic plaques, both of which have been shown to predict myocardial infarction and stroke 4, 5, 6…”

Section: Introductionmentioning

confidence: 99%

Cruciferous and Total Vegetable Intakes Are Inversely Associated With Subclinical Atherosclerosis in Older Adult Women

Blekkenhorst

Bondonno

Lewis

et al. 2018

JAHA

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BackgroundDietary patterns rich in fruits and vegetables are considered to reduce atherosclerotic disease presentation and are reported to be inversely associated with subclinical measures of atherosclerosis, such as carotid artery intima‐media thickness (IMT) and plaque. However, the effect of vegetable intake alone, and relationships to specific types of vegetables containing different phytochemical profiles, is important. The aim of this study was to investigate the associations of total vegetable intake and specific vegetables grouped according to phytochemical constituents with common carotid artery IMT (CCA‐IMT) and carotid plaque severity in a cohort of older adult women (aged ≥70 years).Methods and ResultsTotal vegetable intake was calculated at baseline (1998) using a validated food frequency questionnaire. Vegetable types included cruciferous, allium, yellow/orange/red, leafy green, and legumes. In 2001, CCA‐IMT (n=954) and carotid focal plaque (n=968) were assessed using high‐resolution B‐mode carotid ultrasonography. Mean (SD) total vegetable intake was 199.9 (78.0) g/d. Women consuming ≥3 servings of vegetables each day had ≈4.6% to 5.0% lower mean CCA‐IMT (P=0.014) and maximum CCA‐IMT (P=0.004) compared with participants consuming <2 servings of vegetables. For each 10 g/d higher in cruciferous vegetable intake, there was an associated 0.006 mm (0.8%) lower mean CCA‐IMT (P<0.01) and 0.007 mm (0.8%) lower maximum CCA‐IMT (P<0.01). Other vegetable types were not associated with CCA‐IMT (P>0.05). No associations were observed between vegetables and plaque severity (P>0.05).ConclusionsIncreasing vegetables in the diet with a focus on consuming cruciferous vegetables may have benefits for the prevention of subclinical atherosclerosis in older adult women.Clinical Trial Registration URL: http://www.anzctr.org.au. Unique identifier: ACTRN12615000750583.

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“…Intima media thickness (IMT) of the carotid arteries measured by high resolution B-mode ultrasound is a widely accepted non-invasive marker of subclinical atherosclerosis (9). In addition, in view of its correlation with coronary atherosclerosis and its capacity to predict incident coronary events, carotid IMT has been proposed as a surrogate marker of coronary atherosclerosis (10).…”

Section: Introductionmentioning

confidence: 99%

Abdominal obesity and low-grade systemic inflammation as markers of subclinical organ damage in type 2 diabetes

Dahlén

Tengblad

Länne

et al. 2014

Diabetes & Metabolism

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SummaryAim:The aim of this study was to explore associations between abdominal obesity, inflammatory markers, and subclinical organ damage in 740 patients with type 2 diabetes. Methods:Waist circumference (WC) and sagittal abdominal diameter (SAD) was measured. Blood samples were analyzed for; C-reactive protein (CRP) and IL-6. Carotid intima-media thickness (IMT) was evaluated by ultrasonography. Aortic pulse wave velocity (PWV) was measured with applanation tonometry. Results:Abdominal obesity measured as SAD and WC were significantly correlated with; IL-6 (WC r=0.27, p<0.001, SAD r=031, p<0.001 ), CRP (WC r=0,29, p <0.001, SAD r=0,29, p <0.001), IMT (WC r=0.09 p=0.013, SAD r=0.11, p=0.003) and PWV (WC r=0.18, p<0.001, SAD r=0.21, p <0.001). In multiple linear regressions with IMT or PWV as dependent variable and age, sex, statins, systolic blood pressure (SBP), Body Mass Index (BMI), CRP and HbA1c, as independent variables, both SAD and WC, remained associated with IMT and PWV. In stepwise linear regression, entering both SAD and WC, the association between SAD and PWV was stronger than the association between WC and PWV. Conclusion:We conclude that SAD and WC are feasible measures of obesity that provides information on inflammation, atherosclerosis and arterial stiffness in type 2 diabetes. However, SAD was slightly more robustly associated to subclinical organ damage, compared with WC.

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Prediction of Clinical Cardiovascular Events With Carotid Intima-Media Thickness

Cited by 2,712 publications

References 25 publications

Cadmium, Carotid Atherosclerosis, and Incidence of Ischemic Stroke

Cadmium, Carotid Atherosclerosis, and Incidence of Ischemic Stroke

Cruciferous and Total Vegetable Intakes Are Inversely Associated With Subclinical Atherosclerosis in Older Adult Women

Abdominal obesity and low-grade systemic inflammation as markers of subclinical organ damage in type 2 diabetes

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