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 Tschiderer, Lisa Seekircher, Raffaele Izzo, Costantino Mancusi, Maria V Manzi, Damiano Baldassarre, Mauro Amato, Elena Tremoli, Fabrizio Veglia, Tomi-Pekka Tuomainen, Jussi Kauhanen, Ari Voutilainen, Bernhard Iglseder, Lars Lind, Tatjana Rundek, Moise Desvarieux, Akihiko Kato, Eric de Groot, Gülay Aşçi, Ercan OkStefan Agewall, Joline W J Beulens, Christopher D Byrne, Philip C Calder, Hertzel C Gerstein, Paolo Gresele, Gerhard Klingenschmid, Michiaki Nagai, Michael H Olsen, Grace Parraga, Maya S Safarova, Naveed Sattar, Michael Skilton, Coen D A Stehouwer, Heiko Uthoff, Michiel A van Agtmael, Amber A van der Heijden, Dorota A Zozulińska-Ziółkiewicz, Hyun-Woong Park, Moo-Sik Lee, Jang-Ho Bae, Oscar Beloqui, Manuel F Landecho, Matthieu Plichart, Pierre Ducimetiere, Jean Philippe Empana, Lena Bokemark, Göran Bergström, Caroline Schmidt, Jing Liu, P. Willeit*, Proof‐ATHERO Study Group

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

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; I2=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; I2=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]; I2=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.

Original languageEnglish
Article numbere027657
Number of pages33
JournalJournal of the American Heart Association
Volume12
Issue number12
DOIs
Publication statusPublished - 20 Jun 2023

Keywords

  • Humans
  • Female
  • Middle Aged
  • Male
  • Carotid Intima-Media Thickness
  • Prospective Studies
  • Risk Factors
  • Plaque, Atherosclerotic
  • Carotid Artery, Common/diagnostic imaging
  • Carotid Artery Diseases/diagnostic imaging

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