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Normative values for carotid intima media thickness and its progression: Are they transferrable outside of their cohort of origin?
Goethe Univ Frankfurt, Dept Neurol, Frankfurt, Germany..
Univ Milan, Dipartimento Sci Farmacol & Biomol, I-20122 Milan, Italy.;Bassini Hosp, SISA Ctr Study Atherosclerosis, Cinisello Balsamo, Italy..
Tufts Univ, Sch Med, Tufts Med Ctr, Boston, MA 02111 USA..
Maastricht Univ, Dept Internal Med, Med Ctr, NL-6200 MD Maastricht, Netherlands.;Maastricht Univ, Cardiovasc Res Inst Maastricht CARIM, Med Ctr, NL-6200 MD Maastricht, Netherlands..
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2016 (English)In: European Journal of Preventive Cardiology, ISSN 2047-4873, E-ISSN 2047-4881, Vol. 23, no 11, 1165-1173 p.Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
2016. Vol. 23, no 11, 1165-1173 p.
Keyword [en]
Intima media thickness, normal value, ethnicity, geographic, hazard ratio, cardiovascular risk
National Category
Cardiac and Cardiovascular Systems
URN: urn:nbn:se:uu:diva-305947DOI: 10.1177/2047487315625543ISI: 000380922600007PubMedID: 26746227OAI: oai:DiVA.org:uu-305947DiVA: diva2:1044516
German Research Foundation (DFG)
Available from: 2016-11-03 Created: 2016-10-24 Last updated: 2016-11-03Bibliographically approved

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