Abstract
Objective
B-mode ultrasound measurement of the carotid intima-media thickness (CIMT) is a widely
used marker for atherosclerosis and is associated with future cardiovascular events.
This article provides a review and meta-analysis of the published evidence on the
association of CIMT with future cardiovascular events and its additional value to
traditional cardiovascular risk prediction models.
Methods
A systematic review and meta-analysis of the evidence on the association of CIMT with
future cardiovascular events and the additional value of CIMT to traditional cardiovascular
risk prediction models was conducted. The association of CIMT with future cardiovascular
events and the additional value of CIMT were calculated using random effects analysis.
Results
The literature search yielded 1196 articles of which 15 articles provided sufficient
data for the meta-analysis. A 1 SD increase in CIMT was predictive for myocardial
infarction (HR 1.26, 95% CI 1.20–1.31) and for stroke (HR 1.31, 95% CI 1.26–1.36).
A 0.1 mm increase in CIMT was predictive for myocardial infarction (HR 1.15, 95% CI
1.12–1.18) and for stroke (HR 1.17, 95% CI 1.15–1.21). The overall performance of
risk prediction models did not significantly increase after addition of CIMT data.
The areas under the curve increased from 0.726 to 0.729 (p = 0.8).
Conclusions
CIMT as measured by B-mode ultrasound is associated with future cardiovascular events.
However, the addition of CIMT to traditional cardiovascular risk prediction models
does not lead to a statistical significantly increase in performance of those models.
Keywords
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Article info
Publication history
Published online: February 11, 2013
Accepted:
January 16,
2013
Received in revised form:
January 16,
2013
Received:
October 11,
2012
Identification
Copyright
© 2013 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
