Segment-specific association of carotid-intima-media thickness with cardiovascular risk factors – findings from the STAAB cohort study

Abstract

Background The guideline recommendation to not measure carotid intima-media thickness (CIMT) for cardiovascular risk prediction is based on the assessment of just one single carotid segment. We evaluated whether there is a segment-specific association between different measurement locations of CIMT and cardiovascular risk factors. Methods Subjects from the population-based STAAB cohort study comprising subjects aged 30 to 79 years of the general population from Würzburg, Germany, were investigated. CIMT was measured on the far wall of both sides in three different predefined locations: common carotid artery (CCA), bulb, and internal carotid artery (ICA). Diabetes, dyslipidemia, hypertension, smoking, and obesity were considered as risk factors. In multivariable logistic regression analysis, odds ratios of risk factors per location were estimated for the endpoint of individual age- and sex-adjusted 75th percentile of CIMT. Results 2492 subjects were included in the analysis. Segment-specific CIMT was highest in the bulb, followed by CCA, and lowest in the ICA. Dyslipidemia, hypertension, and smoking were associated with CIMT, but not diabetes and obesity. We observed no relevant segment-specific association between the three different locations and risk factors, except for a possible interaction between smoking and ICA. Conclusions As no segment-specific association between cardiovascular risk factors and CIMT became evident, one simple measurement of one location may suffice to assess the cardiovascular risk of an individual.

Effect of a 6-Month Controlled Lifestyle Intervention on Common Carotid Intima-Media Thickness

“…A strength of our study is the use of a strict standardized measurement protocol and the averaging of four measurements per person per time point. Moreover, all ultrasound scans were conducted by the same technician (and with the same device), which excludes confounding due to inter-operator variability (13). In addition, repeatability of ultrasound measurements was high and comparable to previous studies (36,56).…”

Functional versus morphological assessment of vascular age in patients with coronary heart disease

“…For the determination of our patients´ individual VA via cIMT, both the mean of the left and right CCA and the mean of all means were used. There is evidence that one single site of measurement may be sufficient to assess individual cardiovascular risk 35 . Best reproducibility was shown for the mean cIMT compared to the maximum and minimum value 21 .…”

Healthy lifestyle changes favourably affect common carotid intima-media thickness: the Healthy Lifestyle Community Programme (cohort 2)

“…A cut-off value for mean ccIMT of 0⋅8 mm, as used in our study, has been widely utilised as a threshold for describing what constitutes elevated mean ccIMT values (39) . It has furthermore been proposed that the age-, sex- and race-specific 75th percentile of mean ccIMT (derived from large cohort studies) should be used as a cut-off value (1,40) . In our study population (evaluable participants; n 126), the 75th percentile of baseline mean ccIMT was 0⋅786 mm, which confirms the usefulness of 0⋅800 mm as a cut-off value in our study.…”

“…A strength of the present study is the use of a no-intervention control group, a strict standardised measurement protocol (1,19,55) , several follow-up time points, high repeatability (39) and having all ccIMT measurements conducted by the same technician and with the same device (1,40) .…”