Normative values for carotid intima media thickness and its progression: Are they transferrable outside of their cohort of origin?

Ximing Liao; Giuseppe D. Norata; Joseph F. Polak; Coen D. A. Stehouwer; Alberico Catapano; Tatjana Rundek; Marat Ezhov; Dirk Sander; Simon G. Thompson; Matthias W. Lorenz; Tatyana Balakhonova; Maya Safarova; Liliana Grigore; Jean-Philippe Empana; Hung-Ju Lin; Stela McLachlan; Lena Bokemark; Kimmo Ronkainen; Ulf Schminke; Lars Lind; Peter Willeit; David N. Yanez; Helmuth Steinmetz; Holger Poppert; Moise Desvarieux; M. Arfan Ikram; Stein Harald Johnsen; Bernhard Iglseder; Alfonsa Friera; Wuxiang Xie; Matthieu Plichart; Ta-Chen Su; Sathanur R. Srinivasan; Caroline Schmidt; Tomi-Pekka Tuomainen; Henry Volzke; Giel Nijpels; Johann Willeit; Oscar H. Franco; Carmen Suarez; Dong Zhao; Pierre Ducimetiere; Kuo-Liong Chien; Christine Robertson; Goran Bergstrom; Jussi Kauhanen; Marcus Dorr; Jaqueline M. Dekker; Stefan Kiechl; Matthias Sitzer; Horst Bickel; Ralph L. Sacco; Albert Hofman; Ellisiv B. Mathiesen; Rafael Gabriel; Jing Liu; Gerald Berenson; Maryam Kavousi; Jackie F. Price

doi:10.1177/2047487315625543

Normative values for carotid intima media thickness and its progression: Are they transferrable outside of their cohort of origin?

Ximing Liao, Giuseppe D. Norata, Joseph F. Polak, Coen D. A. Stehouwer, Alberico Catapano, Tatjana Rundek, Marat Ezhov, Dirk Sander, Simon G. Thompson, Matthias W. Lorenz^*, Tatyana Balakhonova, Maya Safarova, Liliana Grigore, Jean-Philippe Empana, Hung-Ju Lin, Stela McLachlan, Lena Bokemark, Kimmo Ronkainen, Ulf Schminke, Lars LindPeter Willeit, David N. Yanez, Helmuth Steinmetz, Holger Poppert, Moise Desvarieux, M. Arfan Ikram, Stein Harald Johnsen, Bernhard Iglseder, Alfonsa Friera, Wuxiang Xie, Matthieu Plichart, Ta-Chen Su, Sathanur R. Srinivasan, Caroline Schmidt, Tomi-Pekka Tuomainen, Henry Volzke, Giel Nijpels, Johann Willeit, Oscar H. Franco, Carmen Suarez, Dong Zhao, Pierre Ducimetiere, Kuo-Liong Chien, Christine Robertson, Goran Bergstrom, Jussi Kauhanen, Marcus Dorr, Jaqueline M. Dekker, Stefan Kiechl, Matthias Sitzer, Horst Bickel, Ralph L. Sacco, Albert Hofman, Ellisiv B. Mathiesen, Rafael Gabriel, Jing Liu, Gerald Berenson, Maryam Kavousi, Jackie F. Price

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Background The clinical use of carotid intima media thickness (cIMT) requires normal values, which may be subject to variation of geographical factors, ethnicity or measurement details. The influence of these factors has rarely been studied. The aim of this study was to determine whether normative cIMT values and their association with event risk are generalizable across populations. Design Meta-analysis of individual participant data. Method From 22 general population cohorts from Europe, North America and Asia we selected subjects free of cardiovascular disease. Percentiles of cIMT and cIMT progression were assessed separately for every cohort. Cox proportional hazards models for vascular events were used to estimate hazard ratios for cIMT in each cohort. The estimates were pooled across Europe, North America and Asia, with random effects meta-analysis. The influence of geography, ethnicity and ultrasound protocols on cIMT values and on the hazard ratios was examined by meta-regression. Results Geographical factors, ethnicity and the ultrasound protocol had influence neither on the percentiles of cIMT and its progression, nor on the hazard ratios of cIMT for vascular events. Heterogeneity for percentiles of cIMT and cIMT progression was too large to create meaningful normative values. Conclusions The distribution of cIMT values is too heterogeneous to define universal or regional population reference values. CIMT values vary widely between different studies regardless of ethnicity, geographic location and ultrasound protocol. Prediction of vascular events with cIMT values was more consistent across all cohorts, ethnicities and regions.

Original language	English
Pages (from-to)	1165-1173
Journal	European Journal of Preventive Cardiology
Volume	23
Issue number	11
DOIs	https://doi.org/10.1177/2047487315625543
Publication status	Published - Jul 2016

Keywords

Intima media thickness
normal value
ethnicity
geographic
hazard ratio
cardiovascular risk

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10.1177/2047487315625543

Cite this

Liao, X., Norata, G. D., Polak, J. F., Stehouwer, C. D. A., Catapano, A., Rundek, T., Ezhov, M., Sander, D., Thompson, S. G., Lorenz, M. W., Balakhonova, T., Safarova, M., Grigore, L., Empana, J.-P., Lin, H.-J., McLachlan, S., Bokemark, L., Ronkainen, K., Schminke, U., ... Price, J. F. (2016). Normative values for carotid intima media thickness and its progression: Are they transferrable outside of their cohort of origin? European Journal of Preventive Cardiology, 23(11), 1165-1173. https://doi.org/10.1177/2047487315625543

@article{3def18a75dd5403fa98d4ffb390dbc2c,

title = "Normative values for carotid intima media thickness and its progression: Are they transferrable outside of their cohort of origin?",

abstract = "Background The clinical use of carotid intima media thickness (cIMT) requires normal values, which may be subject to variation of geographical factors, ethnicity or measurement details. The influence of these factors has rarely been studied. The aim of this study was to determine whether normative cIMT values and their association with event risk are generalizable across populations. Design Meta-analysis of individual participant data. Method From 22 general population cohorts from Europe, North America and Asia we selected subjects free of cardiovascular disease. Percentiles of cIMT and cIMT progression were assessed separately for every cohort. Cox proportional hazards models for vascular events were used to estimate hazard ratios for cIMT in each cohort. The estimates were pooled across Europe, North America and Asia, with random effects meta-analysis. The influence of geography, ethnicity and ultrasound protocols on cIMT values and on the hazard ratios was examined by meta-regression. Results Geographical factors, ethnicity and the ultrasound protocol had influence neither on the percentiles of cIMT and its progression, nor on the hazard ratios of cIMT for vascular events. Heterogeneity for percentiles of cIMT and cIMT progression was too large to create meaningful normative values. Conclusions The distribution of cIMT values is too heterogeneous to define universal or regional population reference values. CIMT values vary widely between different studies regardless of ethnicity, geographic location and ultrasound protocol. Prediction of vascular events with cIMT values was more consistent across all cohorts, ethnicities and regions.",

keywords = "Intima media thickness, normal value, ethnicity, geographic, hazard ratio, cardiovascular risk",

author = "Ximing Liao and Norata, {Giuseppe D.} and Polak, {Joseph F.} and Stehouwer, {Coen D. A.} and Alberico Catapano and Tatjana Rundek and Marat Ezhov and Dirk Sander and Thompson, {Simon G.} and Lorenz, {Matthias W.} and Tatyana Balakhonova and Maya Safarova and Liliana Grigore and Jean-Philippe Empana and Hung-Ju Lin and Stela McLachlan and Lena Bokemark and Kimmo Ronkainen and Ulf Schminke and Lars Lind and Peter Willeit and Yanez, {David N.} and Helmuth Steinmetz and Holger Poppert and Moise Desvarieux and Ikram, {M. Arfan} and Johnsen, {Stein Harald} and Bernhard Iglseder and Alfonsa Friera and Wuxiang Xie and Matthieu Plichart and Ta-Chen Su and Srinivasan, {Sathanur R.} and Caroline Schmidt and Tomi-Pekka Tuomainen and Henry Volzke and Giel Nijpels and Johann Willeit and Franco, {Oscar H.} and Carmen Suarez and Dong Zhao and Pierre Ducimetiere and Kuo-Liong Chien and Christine Robertson and Goran Bergstrom and Jussi Kauhanen and Marcus Dorr and Dekker, {Jaqueline M.} and Stefan Kiechl and Matthias Sitzer and Horst Bickel and Sacco, {Ralph L.} and Albert Hofman and Mathiesen, {Ellisiv B.} and Rafael Gabriel and Jing Liu and Gerald Berenson and Maryam Kavousi and Price, {Jackie F.}",

year = "2016",

month = jul,

doi = "10.1177/2047487315625543",

language = "English",

volume = "23",

pages = "1165--1173",

journal = "European Journal of Preventive Cardiology",

issn = "2047-4873",

publisher = "Oxford University Press",

number = "11",

}

Liao, X, Norata, GD, Polak, JF, Stehouwer, CDA, Catapano, A, Rundek, T, Ezhov, M, Sander, D, Thompson, SG, Lorenz, MW, Balakhonova, T, Safarova, M, Grigore, L, Empana, J-P, Lin, H-J, McLachlan, S, Bokemark, L, Ronkainen, K, Schminke, U, Lind, L, Willeit, P, Yanez, DN, Steinmetz, H, Poppert, H, Desvarieux, M, Ikram, MA, Johnsen, SH, Iglseder, B, Friera, A, Xie, W, Plichart, M, Su, T-C, Srinivasan, SR, Schmidt, C, Tuomainen, T-P, Volzke, H, Nijpels, G, Willeit, J, Franco, OH, Suarez, C, Zhao, D, Ducimetiere, P, Chien, K-L, Robertson, C, Bergstrom, G, Kauhanen, J, Dorr, M, Dekker, JM, Kiechl, S, Sitzer, M, Bickel, H, Sacco, RL, Hofman, A, Mathiesen, EB, Gabriel, R, Liu, J, Berenson, G, Kavousi, M & Price, JF 2016, 'Normative values for carotid intima media thickness and its progression: Are they transferrable outside of their cohort of origin?', European Journal of Preventive Cardiology, vol. 23, no. 11, pp. 1165-1173. https://doi.org/10.1177/2047487315625543