Common Carotid Intima-Media Thickness Measurements in Cardiovascular Risk Prediction: A Meta-analysis
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CONTEXT: The evidence that measurement of the common carotid intima-media thickness (CIMT) improves the risk scores in prediction of the absolute risk of cardiovascular events is inconsistent. OBJECTIVE: To determine whether common CIMT has added value in 10-year risk prediction of first-time myocardial infarctions or strokes, above that of the Framingham Risk Score. DATA SOURCES: Relevant studies were identified through literature searches of databases (PubMed from 1950 to June 2012 and EMBASE from 1980 to June 2012) and expert opinion. STUDY SELECTION: Studies were included if participants were drawn from the general population, common CIMT was measured at baseline, and individuals were followed up for first-time myocardial infarction or stroke. DATA EXTRACTION: Individual data were combined into 1 data set and an individual participant data meta-analysis was performed on individuals without existing cardiovascular disease. RESULTS: We included 14 population-based cohorts contributing data for 45,828 individuals. During a median follow-up of 11 years, 4007 first-time myocardial infarctions or strokes occurred. We first refitted the risk factors of the Framingham Risk Score and then extended the model with common CIMT measurements to estimate the absolute 10-year risks to develop a first-time myocardial infarction or stroke in both models. The C statistic of both models was similar (0.757; 95% CI, 0.749-0.764; and 0.759; 95% CI, 0.752-0.766). The net reclassification improvement with the addition of common CIMT was small (0.8%; 95% CI, 0.1%-1.6%). In those at intermediate risk, the net reclassification improvement was 3.6% in all individuals (95% CI, 2.7%-4.6%) and no differences between men and women. CONCLUSION: The addition of common CIMT measurements to the Framingham Risk Score was associated with small improvement in 10-year risk prediction of first-time myocardial infarction or stroke, but this improvement is unlikely to be of clinical importance.
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Carotid intima-media thickness measurement is inferior to coronary artery calcium score and carotid plaque detection.
“while the measurement of the carotid intima-media thickness is inferior to CAC score and carotid plaque detection [16,24,25].”
From 2019 ESC/EAS guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk (2019) · cites this paper as [24]
Adding IMT measurement does not increase the ability of the Framingham Risk Score to predict risk.
“reports of other countries have revealed that adding the result of IMT measurement does not increase the ability of risk prediction by the Framingham Risk Score33).”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [33]
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Kadota, A., Miura, K., Okamura, T., Fujiyoshi, A., Ohkubo, T., Kadowaki, T., Takashima, N., Hisamatsu, T., Nakamura, Y., Kasagi, F., et al. (2013) · Journal of Atherosclerosis and Thrombosis · doi:10.5551/jat.17244 · Cited by 51 · see citing works
Review on cardiovascular risk prediction
Ruwanpathirana, T., Owen, A., & Reid, C. M. (2015) · Cardiovascular Therapeutics · doi:10.1111/1755-5922.12110 · Cited by 31 · see citing works
- Authors
- Den Ruijter, H. M., Peters, S. A. E., Anderson, T. J., Britton, A. R., Dekker, J. M., Eijkemans, M. J., Engström, G., Evans, G. W., de Graaf, J., Grobbee, D. E., Hedblad, B., Hofman, A., Holewijn, S., Ikeda, A., Kavousi, M., Kitagawa, K., Kitamura, A., Koffijberg, H., Lonn, E. M., Lorenz, M. W., Mathiesen, E. B., Nijpels, G., Okazaki, S., O’Leary, D. H., Polak, J. F., Price, J. F., Robertson, C., Rembold, C. M., Rosvall, M., Rundek, T., Salonen, J. T., Sitzer, M., Stehouwer, C. D. A., Witteman, J. C., Moons, K. G., & Bots, M. L.
- Affiliations
- University College London (GB)
- Amsterdam UMC Location Vrije Universiteit Amsterdam (NL)
- Lund University (SE)
- Radboud University Medical Center (NL)
- University Malaya Medical Centre (MY)
- Erasmus MC (NL)
- The University of Osaka (JP)
- Population Health Research Institute (CA)
- Goethe University Frankfurt (DE)
- UiT The Arctic University of Norway (NO)
- Tufts Medical Center (US)
- University of Edinburgh (GB)
- University of Miami (US)
- ORCID
- Peters, Sanne A. E.
- Anderson, Todd J.
- Britton, Annie R.
- Eijkemans, Marinus J.
- Engström, Gunnar
- Evans, Gregory W.
- Grobbee, Diederick E.
- Holewijn, Suzanne
- Ikeda, Ai
- Kavousi, Maryam
- Kitagawa, Kazuo
- Kitamura, Akihiko
- Koffijberg, Hendrik
- Lonn, Eva M.
- Lorenz, Matthias W.
- Mathiesen, Ellisiv B.
- Nijpels, Giel
- Okazaki, Shuhei
- Polak, Joseph F.
- Price, Jackie F.
- Rembold, Christopher M.
- Rosvall, Maria
- Rundek, Tatjana
- Stehouwer, Coen D. A.
- Moons, Karel G.
- Bots, Michiel L.
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 2012-08-22
- Volume
- 308
- Issue
- 8
- Pages
- 796
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- OpenAlex
- W2161407352
- Cited by
- 760
- References
- 49
- Citations by year
- 2026: 21 · 2025: 38 · 2024: 36 · 2023: 40 · 2022: 46 · 2021: 56 · 2020: 62 · 2019: 53 · 2018: 57 · 2017: 64 · 2016: 62 · 2015: 85 · 2014: 73 · 2013: 52 · 2012: 13
- FWCI
- 11.74
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- JAMA (publishedVersion)
- PubMed (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- University of Twente Research Information (acceptedVersion, other-oa)
- Research Publications (Maastricht University) (submittedVersion, other-oa)
- Lund University Publications (Lund University) (submittedVersion)
- Pure Amsterdam UMC (submittedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- University of Twente Research Information (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Funders
- British Heart Foundation
- ZonMw
- National Institutes of Health
- Japan Society for the Promotion of Science (24790882)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- carotid intima-media thickness, cardiovascular risk prediction, Framingham risk score, myocardial infarction, stroke, 10-year risk, net reclassification improvement, atherosclerosis, risk score
- MeSH terms
- Cardiovascular Diseases, Humans, Myocardial Infarction, Predictive Value of Tests, Cohort Studies, Risk Assessment, Stroke, Carotid Intima-Media Thickness
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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