TY - JOUR
T1 - Reference intervals for common carotid intima-media thickness measured with echotracking: relation with risk factors
AU - Engelen, L.
AU - Ferreira, I.
AU - Stehouwer, C.D.
AU - Boutouyrie, P.
AU - Laurent, S.
AU - Dekker, J.M.
AU - Nijpels, G.
AU - Twisk, J.W.R.
AU - Smulders, Y.M.
AU - Filipovsky, J.
AU - Agharazii, M.
PY - 2013
Y1 - 2013
N2 - Aims Common carotid artery intima-media thickness (CCIMT) is widely used as a surrogate marker of atherosclerosis, given its predictive association with cardiovascular disease (CVD). The interpretation of CCIMT values has been hampered by the absence of reference values, however. We therefore aimed to establish reference intervals of CCIMT, obtained using the probably most accurate method at present (i.e. echotracking), to help interpretation of these measures. Methods and results We combined CCIMT data obtained by echotracking on 24 871 individuals (53% men; age range 15-101 years) from 24 research centres worldwide. Individuals without CVD, cardiovascular risk factors (CV-RFs), and BP-, lipid-, and/or glucose-lowering medication constituted a healthy sub-population (n 1/4 4234) used to establish sex-specific equations for percentiles of CCIMT across age. With these equations, we generated CCIMT Z-scores in different reference subpopulations, thereby allowing for a standardized comparison between observed and predicted ('normal') values from individuals of the same age and sex. In the sub-population without CVD and treatment (n 1/4 14 609), and in men and women, respectively, CCIMT Z-scores were independently associated with systolic blood pressure [standardized bs 0.19 (95% CI: 0.16-0.22) and 0.18 (0.15-0.21)], smoking [0.25 (0.19-0.31) and 0.11 (0.04-0.18)], diabetes [0.19 (0.05-0.33) and 0.19 (0.02-0.36)], total-to-HDL cholesterol ratio [0.07 (0.04-0.10) and 0.05 (0.02-0.09)], and body mass index [0.14 (0.12-0.17) and 0.07 (0.04-0.10)]. Conclusion We estimated age- and sex-specific percentiles of CCIMT in a healthy population and assessed the association of CVRFs with CCIMT Z-scores, which enables comparison of IMT values for (patient) groups with different cardiovascular risk profiles, helping interpretation of such measures obtained both in research and clinical settings. © 2012 The Author All rights reserved.
AB - Aims Common carotid artery intima-media thickness (CCIMT) is widely used as a surrogate marker of atherosclerosis, given its predictive association with cardiovascular disease (CVD). The interpretation of CCIMT values has been hampered by the absence of reference values, however. We therefore aimed to establish reference intervals of CCIMT, obtained using the probably most accurate method at present (i.e. echotracking), to help interpretation of these measures. Methods and results We combined CCIMT data obtained by echotracking on 24 871 individuals (53% men; age range 15-101 years) from 24 research centres worldwide. Individuals without CVD, cardiovascular risk factors (CV-RFs), and BP-, lipid-, and/or glucose-lowering medication constituted a healthy sub-population (n 1/4 4234) used to establish sex-specific equations for percentiles of CCIMT across age. With these equations, we generated CCIMT Z-scores in different reference subpopulations, thereby allowing for a standardized comparison between observed and predicted ('normal') values from individuals of the same age and sex. In the sub-population without CVD and treatment (n 1/4 14 609), and in men and women, respectively, CCIMT Z-scores were independently associated with systolic blood pressure [standardized bs 0.19 (95% CI: 0.16-0.22) and 0.18 (0.15-0.21)], smoking [0.25 (0.19-0.31) and 0.11 (0.04-0.18)], diabetes [0.19 (0.05-0.33) and 0.19 (0.02-0.36)], total-to-HDL cholesterol ratio [0.07 (0.04-0.10) and 0.05 (0.02-0.09)], and body mass index [0.14 (0.12-0.17) and 0.07 (0.04-0.10)]. Conclusion We estimated age- and sex-specific percentiles of CCIMT in a healthy population and assessed the association of CVRFs with CCIMT Z-scores, which enables comparison of IMT values for (patient) groups with different cardiovascular risk profiles, helping interpretation of such measures obtained both in research and clinical settings. © 2012 The Author All rights reserved.
U2 - 10.1093/eurheartj/ehs380
DO - 10.1093/eurheartj/ehs380
M3 - Article
SN - 0195-668X
VL - 34
SP - 2368
EP - 2380
JO - European Heart Journal
JF - European Heart Journal
IS - 30
ER -