European Heart Journal Advance Access published online on February 2, 2007
European Heart Journal, doi:10.1093/eurheartj/ehl482
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Carotid intima-media thickness and coronary atherosclerosis: weak or strong relations?
1 Julius Center for Health Sciences and Primary Care, Huispostnummer Str 6.131, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
2 Department of Pharmacological Sciences, E. Grossi Paoletti Center, University of Milan and Cardiologico ‘Monzino’, IRCCS, Milan, Italy
3 Centre de Medecine Preventive Cardiovasculaire, Hopital Broussais Assistance Publique Hopitaux de Paris-Faculte de Medecine Rene Descartes, Paris, France
4 Department of Vascular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
5 Department of Radiology, Tufts University School of Medicine, Boston, MA, USA
6 Department of Neurology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC, USA
Received 14 July 2006; revised 2 January 2007; accepted 4 January 2007.
* Corresponding author. Tel: +31 30 2509352; fax: +31 30 2505485. E-mail address: m.l.bots{at}umcutrecht.nl
AIMS: Measurement of change in carotid intima-media thickness (CIMT) has been proposed as an alternative for the occurrence of cardiovascular (CV) events in the assessment of therapeutic interventions. Nevertheless, criticism has been voiced based on observations indicating a weak relation between CIMT and coronary atherosclerosis as well as on the virtual absence of data showing that progression of CIMT indeed predicts coronary artery disease (CAD) and stroke.
METHODS AND RESULTS: We set out to review the evidence on these issues by performing a literature search on these topics. Of the 34 studies on the relation of CIMT with coronary atherosclerosis, as assessed by angiography (n = 33) or intravascular ultrasound (n = 1), 30 showed a modest positive relationship; the magnitude of which was similar to that found in autopsy studies. Of all studies on CIMT and future CV events (n = 18), 17 showed graded positive relationships. At present, only one study has provided evidence on the relation of change in CIMT and future CV events, showing an increased risk with CIMT progression. The paucity of data on progression and future CV risk is partly attributable to time windows required to complete these studies.
CONCLUSION: The modest relation between CIMT and coronary atherosclerosis most likely reflects variability in atherosclerosis development between the vascular beds rather than limitations of CIMT measurements. Additional data on the relation between change in CIMT and future CV events is required and currently is in progress.
Key Words: Carotid atherosclerosis • Trials • Surrogate endpoints • Hypertension • Statin
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  M. Helfand, D. I. Buckley, M. Freeman, R. Fu, K. Rogers, C. Fleming, and L. L. Humphrey Emerging Risk Factors for Coronary Heart Disease: A Summary of Systematic Reviews Conducted for the U.S. Preventive Services Task Force Ann Intern Med, October 6, 2009; 151(7): 496 - 507. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. P.J. Halcox, A. E. Donald, E. Ellins, D. R. Witte, M. J. Shipley, E. J. Brunner, M. G. Marmot, and J. E. Deanfield Endothelial Function Predicts Progression of Carotid Intima-Media Thickness Circulation, February 24, 2009; 119(7): 1005 - 1012. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. K. Pasquali and J. S. Li Prevention of Future Cardiovascular Disease in High-Risk Pediatric Patients: A Role for Lipid Lowering Therapy? Circ Cardiovasc Qual Outcomes, November 1, 2008; 1(2): 131 - 133. [Full Text] [PDF]
|
|
|
|
 |
|
 J. H. O'Keefe, K. A. Bybee, and C. J. Lavie Is Carotid Intima-Media Thickness a Reliable Clinical Predictor?-Reply-I Mayo Clin. Proc., November 1, 2008; 83(11): 1300 - 1301. [Full Text] [PDF]
|
|
|
|
 |
|
 M Sandrock, C Schulze, D Schmitz, H-H Dickhuth, and A Schmidt-Trucksaess Physical activity throughout life reduces the atherosclerotic wall process in the carotid artery Br. J. Sports Med., October 1, 2008; 42(10): 839 - 844. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. D. Peterson and T. Y. Wang The Great Debate of 2008--How Low to Go in Preventive Cardiology? JAMA, April 9, 2008; 299(14): 1718 - 1720. [Full Text] [PDF]
|
|
|
|
 |
|
 B. G. Brown and A. J. Taylor Does ENHANCE Diminish Confidence in Lowering LDL or in Ezetimibe? N. Engl. J. Med., April 3, 2008; 358(14): 1504 - 1507. [Full Text] [PDF]
|
|
|
|
 |
|
 F. A. Benedetto, G. Tripepi, F. Mallamaci, and C. Zoccali Rate of Atherosclerotic Plaque Formation Predicts Cardiovascular Events in ESRD J. Am. Soc. Nephrol., April 1, 2008; 19(4): 757 - 763. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Junyent, R. Gilabert, D. Zambon, M. Pocovi, M. Mallen, M. Cofan, I. Nunez, F. Civeira, D. Tejedor, and E. Ros Femoral Atherosclerosis In Heterozygous Familial Hypercholesterolemia: Influence Of The Genetic Defect Arterioscler Thromb Vasc Biol, March 1, 2008; 28(3): 580 - 586. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. D. Barth and C. K. Roberts Carotid intima-media thickness and coronary atherosclerosis: weak or strong relations? Eur. Heart J., October 2, 2007; 28(20): 2552 - 2552. [Full Text] [PDF]
|
|
|
|
|
|
A. Simon and G. Chironi The relationship between carotid intima-media thickness and coronary atherosclerosis revisited Eur. Heart J., September 1, 2007; 28(17): 2049 - 2050. [Full Text] [PDF]
|
|
|
|
|
|
J. J.P. Kastelein, S. I. van Leuven, L. Burgess, G. W. Evans, J. A. Kuivenhoven, P. J. Barter, J. H. Revkin, D. E. Grobbee, W. A. Riley, C. L. Shear, et al. Effect of Torcetrapib on Carotid Atherosclerosis in Familial Hypercholesterolemia N. Engl. J. Med., April 19, 2007; 356(16): 1620 - 1630. [Abstract] [Full Text] [PDF]
|
|