Association of Intima-Media Thickness Measured at the Common Carotid Artery With Incident Carotid Plaque: Individual Participant Data Meta-Analysis of 20 Prospective Studies.
Lena TschidererLisa SeekircherRaffaele IzzoCostantino MancusiMaria Virginia ManziDamiano BaldassarreMauro AmatoElena TremoliFabrizio VegliaTomi-Pekka TuomainenJussi KauhanenAri VoutilainenBernhard IglsederLars LindTatjana RundekMoise DesvarieuxAkihiko KatoEric de GrootGülay AşçiErcan OkStefan AgewallJoline Wilhelma Johanna BeulensChristopher D ByrnePhilip C CalderUlagamadesan VenkatesanPaolo GreseleGerhard KlingenschmidMichiaki NagaiMichaels Hecht OlsenGrace ParragaMaya S SafarovaNaveed SattarMichael R SkiltonCoen D A StehouwerHeiko UthoffMichiel A van AgtmaelAmber A van der HeijdenDorota A Zozulinska-ZiolkiewiczHyun-Woong ParkMoo-Sik LeeJang Ho BaeOscar BeloquiManuel F LandechoMatthieu PlichartPierre DucimetiereJean Philippe EmpanaLena BokemarkGöran BergstromCaroline SchmidtSamuela CastelnuovoLaura CalabresiGiuseppe Danilo NorataLiliana GrigoreAlberico Luigi CatapanoDong ZhaoMiao WangJing LiuMohammad Arfan IkramMaryam KavousiMichiel L BotsMichael J SweetingMatthias W LorenzPeter Willeitnull nullPublished in: Journal of the American Heart Association (2023)
Background The association between common carotid artery intima-media thickness (CCA-IMT) and incident carotid plaque has not been characterized fully. We therefore aimed to precisely quantify the relationship between CCA-IMT and carotid plaque development. Methods and Results We undertook an individual participant data meta-analysis of 20 prospective studies from the Proof-ATHERO (Prospective Studies of Atherosclerosis) consortium that recorded baseline CCA-IMT and incident carotid plaque involving 21 494 individuals without a history of cardiovascular disease and without preexisting carotid plaque at baseline. Mean baseline age was 56 years (SD, 9 years), 55% were women, and mean baseline CCA-IMT was 0.71 mm (SD, 0.17 mm). Over a median follow-up of 5.9 years (5th-95th percentile, 1.9-19.0 years), 8278 individuals developed first-ever carotid plaque. We combined study-specific odds ratios (ORs) for incident carotid plaque using random-effects meta-analysis. Baseline CCA-IMT was approximately log-linearly associated with the odds of developing carotid plaque. The age-, sex-, and trial arm-adjusted OR for carotid plaque per SD higher baseline CCA-IMT was 1.40 (95% CI, 1.31-1.50; I 2 =63.9%). The corresponding OR that was further adjusted for ethnicity, smoking, diabetes, body mass index, systolic blood pressure, low- and high-density lipoprotein cholesterol, and lipid-lowering and antihypertensive medication was 1.34 (95% CI, 1.24-1.45; I 2 =59.4%; 14 studies; 16 297 participants; 6381 incident plaques). We observed no significant effect modification across clinically relevant subgroups. Sensitivity analysis restricted to studies defining plaque as focal thickening yielded a comparable OR (1.38 [95% CI, 1.29-1.47]; I 2 =57.1%; 14 studies; 17 352 participants; 6991 incident plaques). Conclusions Our large-scale individual participant data meta-analysis demonstrated that CCA-IMT is associated with the long-term risk of developing first-ever carotid plaque, independent of traditional cardiovascular risk factors.
Keyphrases
- cardiovascular disease
- coronary artery disease
- case control
- cardiovascular risk factors
- systematic review
- blood pressure
- body mass index
- heart failure
- type diabetes
- physical activity
- metabolic syndrome
- randomized controlled trial
- machine learning
- electronic health record
- left ventricular
- smoking cessation
- cardiovascular events
- meta analyses
- fatty acid
- skeletal muscle
- phase iii
- glycemic control
- weight loss
- placebo controlled
- heart rate
- artificial intelligence
- hypertensive patients