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Reference intervals for common carotid intima-media thickness measured with echotracking: relation with risk factors

(2013) EUROPEAN HEART JOURNAL. 34(30). p.2368-U30
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Abstract
Aims: Common carotid artery intima-media thickness (CCIMT) is widely used as a surrogate marker of atherosclerosis, given its predictive association with cardiovascular disease (CVD). The interpretation of CCIMT values has been hampered by the absence of reference values, however. We therefore aimed to establish reference intervals of CCIMT, obtained using the probably most accurate method at present (i.e. echotracking), to help interpretation of these measures. Methods and results: We combined CCIMT data obtained by echotracking on 24 871 individuals (53 men; age range 15-101 years) from 24 research centres worldwide. Individuals without CVD, cardiovascular risk factors (CV-RFs), and BP-, lipid-, and/or glucose-lowering medication constituted a healthy sub-population (n = 4234) used to establish sex-specific equations for percentiles of CCIMT across age. With these equations, we generated CCIMT Z-scores in different reference sub-populations, thereby allowing for a standardized comparison between observed and predicted (normal) values from individuals of the same age and sex. In the sub-population without CVD and treatment (n = 14 609), and in men and women, respectively, CCIMT Z-scores were independently associated with systolic blood pressure [standardized s 0.19 (95 CI: 0.16-0.22) and 0.18 (0.15-0.21)], smoking [0.25 (0.19-0.31) and 0.11 (0.04-0.18)], diabetes [0.19 (0.05-0.33) and 0.19 (0.02-0.36)], total-to-HDL cholesterol ratio [0.07 (0.04-0.10) and 0.05 (0.02-0.09)], and body mass index [0.14 (0.12-0.17) and 0.07 (0.04-0.10)]. Conclusion: We estimated age- and sex-specific percentiles of CCIMT in a healthy population and assessed the association of CV-RFs with CCIMT Z-scores, which enables comparison of IMT values for (patient) groups with different cardiovascular risk profiles, helping interpretation of such measures obtained both in research and clinical settings.
Keywords
VASCULAR-DISEASE, PROSPECTIVE COHORT, ATHEROSCLEROSIS RISK, CARDIOVASCULAR-DISEASE, CORONARY-HEART-DISEASE, Risk factors, Reference intervals, Echotracking, Carotid intima-media thickness, ULTRASOUND, SEX-DIFFERENCES, TASK-FORCE, METAANALYSIS, ARTERY, Atherosclerois, Ageing

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Citation

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Chicago
Engelen, Lian, Isabel Ferreira, Coen D Stehouwer, Pierre Boutouyrie, Stéphane Laurent, the Reference Values Arterial Measurements Collaboration, Ernst Rietzschel, et al. 2013. “Reference Intervals for Common Carotid Intima-media Thickness Measured with Echotracking: Relation with Risk Factors.” European Heart Journal 34 (30): 2368–U30.
APA
Engelen, Lian, Ferreira, I., Stehouwer, C. D., Boutouyrie, P., Laurent, S., Reference Values Arterial Measurements Collaboration, the, Rietzschel, E., et al. (2013). Reference intervals for common carotid intima-media thickness measured with echotracking: relation with risk factors. EUROPEAN HEART JOURNAL, 34(30), 2368–U30.
Vancouver
1.
Engelen L, Ferreira I, Stehouwer CD, Boutouyrie P, Laurent S, Reference Values Arterial Measurements Collaboration the, et al. Reference intervals for common carotid intima-media thickness measured with echotracking: relation with risk factors. EUROPEAN HEART JOURNAL. 2013;34(30):2368–U30.
MLA
Engelen, Lian, Isabel Ferreira, Coen D Stehouwer, et al. “Reference Intervals for Common Carotid Intima-media Thickness Measured with Echotracking: Relation with Risk Factors.” EUROPEAN HEART JOURNAL 34.30 (2013): 2368–U30. Print.
@article{4283750,
  abstract     = {Aims: Common carotid artery intima-media thickness (CCIMT) is widely used as a surrogate marker of atherosclerosis, given its predictive association with cardiovascular disease (CVD). The interpretation of CCIMT values has been hampered by the absence of reference values, however. We therefore aimed to establish reference intervals of CCIMT, obtained using the probably most accurate method at present (i.e. echotracking), to help interpretation of these measures.
Methods and results: We combined CCIMT data obtained by echotracking on 24 871 individuals (53 men; age range 15-101 years) from 24 research centres worldwide. Individuals without CVD, cardiovascular risk factors (CV-RFs), and BP-, lipid-, and/or glucose-lowering medication constituted a healthy sub-population (n = 4234) used to establish sex-specific equations for percentiles of CCIMT across age. With these equations, we generated CCIMT Z-scores in different reference sub-populations, thereby allowing for a standardized comparison between observed and predicted (normal) values from individuals of the same age and sex. In the sub-population without CVD and treatment (n = 14 609), and in men and women, respectively, CCIMT Z-scores were independently associated with systolic blood pressure [standardized s 0.19 (95 CI: 0.16-0.22) and 0.18 (0.15-0.21)], smoking [0.25 (0.19-0.31) and 0.11 (0.04-0.18)], diabetes [0.19 (0.05-0.33) and 0.19 (0.02-0.36)], total-to-HDL cholesterol ratio [0.07 (0.04-0.10) and 0.05 (0.02-0.09)], and body mass index [0.14 (0.12-0.17) and 0.07 (0.04-0.10)]. 
Conclusion: We estimated age- and sex-specific percentiles of CCIMT in a healthy population and assessed the association of CV-RFs with CCIMT Z-scores, which enables comparison of IMT values for (patient) groups with different cardiovascular risk profiles, helping interpretation of such measures obtained both in research and clinical settings.},
  author       = {Engelen, Lian and Ferreira, Isabel and Stehouwer, Coen D and Boutouyrie, Pierre and Laurent, St{\'e}phane and Reference Values Arterial Measurements Collaboration, the and Rietzschel, Ernst and VERMEERSCH, SEBASTIAN and Segers, Patrick and Van Bortel, Lucas and De Bacquer, Dirk and Van daele, Caroline and De Buyzere, Marc},
  issn         = {0195-668X},
  journal      = {EUROPEAN HEART JOURNAL},
  language     = {eng},
  number       = {30},
  pages        = {2368--U30},
  title        = {Reference intervals for common carotid intima-media thickness measured with echotracking: relation with risk factors},
  url          = {http://dx.doi.org/10.1093/eurheartj/ehs380},
  volume       = {34},
  year         = {2013},
}

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