Carotid Intima-Media Thickness and Risk of Cardiovascular Events in High-Risk Patients
Abstract
Background and Purpose: There is epidemiological evidence that increased carotid intima-media thickness (IMT) is a predictor of cardiovascular disease (CVD) events. However, the significance of carotid IMT in high-risk patients in whom risk factors are managed clinically has not been adequately investigated. The purpose of this study was to determine the usefulness of carotid IMT measurement in such patients. Methods: The study comprised 900 outpatients with cardiovascular risk factors or established atherosclerosis. Carotid IMT was calculated as the mean bilateral IMT of the common carotid artery, bifurcation, and internal carotid artery. Baseline vascular risk factors, medications, and history of CVD were recorded at the time of enrollment. The incidence of CVD events was determined prospectively. Results: During a mean follow-up period of 2.6 years, there were 64 CVD events. The relative risk (RR) of a CVD event increased with increased IMT. Association between CVD events and carotid IMT was significant after adjustment for risk factors and history of CVD, showing an increased risk per IMT tertile from the middle tertile (RR, 2.5; 95% confidence interval [CI]: 1.0–6.3) to the highest (RR, 3.6; 95% CI: 1.4–9.0). When patients with a history of CVD were excluded (n = 574), the predictive value of IMT was significant even after adjustment for risk factors (hazard ratio per 1 SD IMT increase was 1.57 [95% CI: 1.11–2.20]). Conclusions: Carotid IMT is an independent predictor of vascular events in high-risk patients in whom risk factors are managed clinically.
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Patients with a history of cerebrovascular disease are a high-risk group for CAD.
“Patients with a history of cerebrovascular disease are known to be a high-risk group for CAD.”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [185]
A history of noncardiogenic cerebral infarction is a high-risk condition for cerebrovascular disease and CAD.
“A history of noncardiogenic cerebral infarction is a high-risk condition for cerebrovascular disease and CAD.”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [185]
In Japan, the 1-year incidence rate for patients with a history of stroke is 0.40-0.45% (4.0-4.5 people/1,000 person-years).
“In Japan, there has been reports revealing that the 1-year incidence rate for patients with a history of stroke is 0.40–0.45% (4.0–4.5 people/1,000 person-years)184, 185).”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [185]
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- Authors
- Kitagawa, K., Hougaku, H., Yamagami, H., Hashimoto, H., Itoh, T., Shimizu, Y., Takahashi, D., Murata, S., Seike, Y., Kondo, K., Hoshi, T., Furukado, S., Abe, Y., Yagita, Y., Sakaguchi, M., Tagaya, M., Etani, H., Fukunaga, R., Nagai, Y., Matsumoto, M., & Hori, M.
- Affiliations
- The University of Osaka (JP)
- Kobe City Medical Center General Hospital (JP)
- Osaka National Hospital (JP)
- Hoshigaoka Medical Center (JP)
- Osaka Minami Medical Center (JP)
- Osaka Hospital (JP)
- Translational Research Informatics Center (Japan) (JP)
- Hiroshima University (JP)
- ORCID
- Venue
- Cerebrovascular Diseases
- Publisher
- S. Karger AG
- Published
- 2007
- Volume
- 24
- Issue
- 1
- Pages
- 35-42
- ISSN
- 1015-9770 (ISSN-L)
- 1421-9786
- OpenAlex
- W2069258108
- Cited by
- 94
- References
- 22
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 2 · 2023: 1 · 2022: 3 · 2021: 5 · 2020: 1 · 2019: 5 · 2018: 4 · 2017: 3 · 2016: 6 · 2015: 8 · 2014: 14 · 2013: 8 · 2012: 8
- FWCI
- 4.67
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Cerebrovascular Diseases (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cerebrovascular and Carotid Artery Diseases
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- carotid intima-media thickness, cardiovascular events, high-risk patients, cardiovascular risk factors, atherosclerosis, cardiovascular risk prediction, carotid artery, vascular risk
- MeSH terms
- Aged, Cardiovascular Diseases, Carotid Artery, Internal, Female, Follow-Up Studies, Humans, Japan, Male, Middle Aged, Predictive Value of Tests, Prospective Studies, Risk Factors, Time Factors, Ultrasonography, Incidence, Proportional Hazards Models, Odds Ratio, Carotid Artery, Common, Tunica Intima, Tunica Media, Risk Assessment, Atherosclerosis, Kaplan-Meier Estimate
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