Regional and demographic variations of Carotid artery Intima and Media Thickness (CIMT): A Systematic review and meta-analysis

Abeysuriya, V.; Perera, Ruwanthi; Wickremasinghe, Ananda R.

doi:10.1371/journal.pone.0268716

Cited by 12 publications

(5 citation statements)

References 119 publications

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“…In this review, it was reported that CIMT increases with age, and the average is 0.76 in the 60-69 years age range. In our study, the median and mean age were 66, and the mean IMT was found to be 0.71±0.14 and 0.69±0.13 in individuals without stenosis, which is correlated with the study results [17]. In a study investigating the characteristics of carotid plaques, the plaques, which were described as predominantly hypoechoic and soft plaques in our study, were found to be associated with cerebrovascular symptomatic individuals.…”

Section: Discussionsupporting

confidence: 88%

Factors Affecting Carotid Artery Stenosis in the Elderly Living at High Altitudes

Sukun,

Önal

2023

Cureus

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Background: Factors affecting carotid artery stenosis have been generally investigated. However, considering the protective effect of altitude, studies on elderly individuals at high altitudes are few. Our aim is to investigate the systematic adaptive changes caused by high-altitude exposure through the causes of carotid artery stenosis. Materials and methods: Carotid Doppler ultrasound was performed on 250 patients over the age of 50 years. The patients' age, gender, height, weight, smoking history, place of residence, and presence of comorbidities were questioned. Those with diabetes, hypertension, hyperlipidemia, and coronary disease were excluded from the study. Those who did not reside at high altitudes were excluded from the study. One hundred and thirty-five patients were included in the study. Carotid artery Doppler findings and biochemical parameters were recorded. Factors affecting stenosis in the carotid arteries were compared. Results: In our study, the factors affecting carotid stenosis were determined to be age, gender, presence of plaque, plaque type, and mean carotid intima-media thickness (CIMT). The mean CIMT of the patients was calculated as 0.71±0.14 mm. The mean CIMT measurement level was significantly higher in patients with plaque in the carotid artery (p<0.05). According to receiver operating characteristic curves, CIMT values higher than 0.72 mm increase plaque and stenosis formation in the common carotid artery (CCA) and internal carotid artery (ICA) in elderly people living at high altitudes (p<0.05, area under the curve [AUC]: 0.71-0.83). Conclusions: The most important factors affecting carotid stenosis in individuals living at high altitudes are age, gender, CIMT, plaque, and plaque type. When soft plaques were detected, the risk of stenosis was found to be higher than in calcific plaques. Additionally, the number of factors affecting stenosis was greater on the left (ICA). This suggests that the left carotid system is more vulnerable. It can be said that in elderly individuals living at high altitudes, a CIMT higher than 0.72 mm is a cutoff value in the presence of plaque and stenosis in the carotid arteries.

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Section: Discussionsupporting

confidence: 88%

Factors Affecting Carotid Artery Stenosis in the Elderly Living at High Altitudes

Sukun,

Önal

2023

Cureus

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“…A systematic review by Abeysuriya et al identified variations in mean CIMT among healthy persons by sex, age groups and regions, with higher mean CIMT values among males across all regions. Overall mean CIMT was highest in the WHO AFRO (African) region (0.72 mm) and increased with age, with mean CIMT of 0.59 mm, 0.63 mm, 0.76 mm and 0.83 mm in age groups 40-49 years, 50-59 years, 60-69 years and >70 years respectively (48). Our threshold CIMT value is comparable to the mean CIMT reported for the African region and when we consider age differences in mean CIMT, our reference value is higher than thresholds reported for ages 40-59 years.…”

Section: Discussion Prevalence Of Subclinical Atherosclerosismentioning

confidence: 96%

Prevalence and risk factors for subclinical atherosclerosis amongst adults living with HIV in University of Abuja Teaching Hospital, Gwagwalada

Adedokun

Kwaghe²,

Adedokun³

et al. 2023

Front. Reprod. Health

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BackgroundSubclinical atherosclerosis characterizes cardiovascular diseases (CVD), and Human Immunodeficiency Virus (HIV) infection and antiretroviral therapy (ART) are identified risk factors for atherosclerosis. Meanwhile, data on HIV and atherosclerosis in Nigeria are limited.ObjectivesWe sought to estimate the prevalence of subclinical atherosclerosis and associated risk factors amongst adult persons living with HIV/AIDS (PLHIV) enrolled at University of Abuja Teaching Hospital, Gwagwalada, Abuja (UATH).MethodsThis was a cross-sectional study of 277 consecutively selected PLHIV ≥18 years enrolled for HIV care and treatment at UATH. Pretested structured questionnaire was used to collect data from consenting ART-experienced and ART-naïve patients on risk factors of atherosclerosis. Carotid intima media thickness (CIMT) ≥0.71 mm as measured by Doppler ultrasonography was used to identify patients with sub-clinical atherosclerosis. Two logistic regression models with (Model-A) and without (Model-B) traditional risk factors were fitted to identify risk factors of subclinical atherosclerosis.ResultsParticipants' mean age was 39.44 ± 10.71 years with female preponderance (64.26%). Overall prevalence of subclinical atherosclerosis was 43.32% (62.25% in ART-experienced). Model-A identified male sex [AOR 4.33(1.74–10.76), p = 0.002], advancing age [30–39 years AOR 5.95(1.31–26.96), p = 0.021]; ≥40 years AOR 19.51(4.30–88.56), p ≤ 0.001), advancing HIV infection [≥WHO stage II AOR 4.19(1.11–15.92), p = 0.035], hypercholesterolemia [AOR 3.88(1.47–10.25), p ≤ 0.001] and ≥5 year duration on ART [AOR 9.05(3.16–25.92), p ≤ 0.001] as risk factors of subclinical atherosclerosis. In Model-B (excluding traditional risk factors) on the other hand, advancing HIV infection [≥WHO stage II AOR 3.93(1.19–13.042), p = 0.025] and duration on ART [≥5 years AOR 11.43(4.62–28.29), p = 0.001] were found as risk factors of subclinical atherosclerosis.ConclusionSubclinical atherosclerosis was higher in ART-experienced patients, and this was irrespective of presence or absence of traditional risk factors. And advancing HIV disease and duration on ART were found as significant risk factors for subclinical atherosclerosis. We therefore recommend routine CVD risk screening in PLHIV.

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“…There may be ethnic variation also, as the CIMT values were higher in the studies done on the Western population [22,23]. Systemic reviews also showed that Asians have lower mean CIMT values than other ethnic groups [25].…”

Section: Discussionmentioning

confidence: 99%

The Association of Carotid Plaque Size, Carotid Intima-Media Thickness, Resistive Index, and Pulsatility Index With Acute Ischemic Stroke

Kawnayn¹,

Kabir²,

Huq³

et al. 2023

Cureus

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Background: Carotid atherosclerosis is an important etiological factor for ischemic stroke. Early carotid lesion detection may prevent further strokes. Doppler ultrasound measures carotid artery blood flow, intimamedia thickness, stenosis, plaques, and lumen and wall changes.Objective: The objective of this study is to determine the association of carotid plaque size (CPS), carotid intima-media thickness (CIMT), resistive index (RI), and pulsatility index (PI) with acute ischemic stroke.Methodology: A total of 60 participants were taken, including 30 cases and 30 age-and sex-matched controls. Patients with acute ischemic stroke were included as cases and age-and sex-matched healthy volunteers were included as controls. A carotid duplex study was done in both groups, and the findings were compared.Results: The mean age of the ischemic stroke cases was 63.33±10.79 years; more than half were aged >60 years. Male patients were 73.3% and female patients were 26.7% of the cases. Age and gender were statistically similar (p>0.05) in groups (cases and controls). The plaques were homogenous in 30% of patients, calcified in 26.7%, and mixed in 6.7%. About 36.6% of patients did not have any plaque. CPS was greater among cases than controls in the right and left internal and left common carotid arteries; however, it was not statistically significant (p>0.05). The mean CIMT was 0.79±0.10 mm on the right side and 0.90±0.17 mm on the left side among cases. CIMT was significantly higher in the cases group than in the controls (p<0.05). The mean RI was significantly greater in the left common carotid artery (CCA) among the cases than in the controls (p<0.05). Patients aged over 60 years had significantly higher RI and PI values in the left internal carotid artery (ICA) compared to the younger cases (p<0.05). Smoking history had a significant association with left CCA RI and PI values (p<0.05). However, RI, PI, CPS, and CIMT among cases were similar in different groups like diabetic, non-diabetic, hypertensive, and non-hypertensive patients (p>0.05).Conclusion: CIMT was significantly thicker among the patients with ischemic stroke compared to the control group. RI in the left CCA was significantly greater among the stroke patients than in the control group. The age of the patient and smoking habit had an association with RI and PI values. Most of the parameters were found to be significant on the left side, suggesting carotid atherosclerosis may not be symmetrical. A largescale further study is needed to see the association of these variables with ischemic stroke patients.

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Regional and demographic variations of Carotid artery Intima and Media Thickness (CIMT): A Systematic review and meta-analysis

Cited by 12 publications

References 119 publications

Factors Affecting Carotid Artery Stenosis in the Elderly Living at High Altitudes

Factors Affecting Carotid Artery Stenosis in the Elderly Living at High Altitudes

Prevalence and risk factors for subclinical atherosclerosis amongst adults living with HIV in University of Abuja Teaching Hospital, Gwagwalada

The Association of Carotid Plaque Size, Carotid Intima-Media Thickness, Resistive Index, and Pulsatility Index With Acute Ischemic Stroke

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