Objective: to investigate whether measurement of carotid artery intima media thickness (IMT) could be combined with inter-adventitial common carotid artery diameter (CCAD) to improve the predictability of cardiovascular events. Background: The “IMPROVE study” is a prospective, longitudinal study designed to investigate whether cross-sectional IMT and IMT progression are predictors of vascular events in European individuals at high risk of cardiovascular diseases. Methods and results: 3711 subjects (median age 64.4 years; 48% men) with at least three vascular risk factors (VRFs) were recruited in 7 centers in Europe. 3703 patients were monitored for a median of 36.2 months. 215 patients suffered a first cardiovascular event with an incidence of 19.9 per 1000 person-years. In Cox proportional-hazards regression, C-IMT measures were associated with the risk of the combined end point even after adjustment for VRFs (Ptrend <0.005 for all). CCAD was associated with the risk of events independently of VRFs and C-IMTmax (adjusted HR for 1 SD increase: 1.26, 95% CI: 1.08-1.48, p=0.004). Results for cardio and cerebro-vascular events were in line with those observed with the combined end point. By ROC curves analysis, CCAD alone has about the same predictive capacity of the best predictor among C-IMT variables (IMTmean). When combined, IMTmean and CCAD provided a better predictive capacity than conventional VRFs (c-statistic = 0.653 vs. 0.639). The combination of IMTmean, CCAD and VRFs further improved the total predictive capacity (c-statistic 0.669). Conclusions: CCAD and C-IMT are independent predictors of cardiovascular events and together they enhance the predictive capacity of VRFs.
Carotid diameter improves the carotid IMT capacity to predict coronary events : data from the IMPROVE study / D. Baldassarre, M. Amato, E. Tremoli, O. behalf of the IMPROVE study group. - In: THE JOURNAL OF HEART DISEASE. - ISSN 1556-7451. - 7:1(2010 Jul), pp. 61-61. ((Intervento presentato al 15. convegno World Congress on Heart Disease Annual Scientific Session tenutosi a Vancouver nel 2010.
Carotid diameter improves the carotid IMT capacity to predict coronary events : data from the IMPROVE study
D. BaldassarrePrimo
;E. TremoliUltimo
;
2010
Abstract
Objective: to investigate whether measurement of carotid artery intima media thickness (IMT) could be combined with inter-adventitial common carotid artery diameter (CCAD) to improve the predictability of cardiovascular events. Background: The “IMPROVE study” is a prospective, longitudinal study designed to investigate whether cross-sectional IMT and IMT progression are predictors of vascular events in European individuals at high risk of cardiovascular diseases. Methods and results: 3711 subjects (median age 64.4 years; 48% men) with at least three vascular risk factors (VRFs) were recruited in 7 centers in Europe. 3703 patients were monitored for a median of 36.2 months. 215 patients suffered a first cardiovascular event with an incidence of 19.9 per 1000 person-years. In Cox proportional-hazards regression, C-IMT measures were associated with the risk of the combined end point even after adjustment for VRFs (Ptrend <0.005 for all). CCAD was associated with the risk of events independently of VRFs and C-IMTmax (adjusted HR for 1 SD increase: 1.26, 95% CI: 1.08-1.48, p=0.004). Results for cardio and cerebro-vascular events were in line with those observed with the combined end point. By ROC curves analysis, CCAD alone has about the same predictive capacity of the best predictor among C-IMT variables (IMTmean). When combined, IMTmean and CCAD provided a better predictive capacity than conventional VRFs (c-statistic = 0.653 vs. 0.639). The combination of IMTmean, CCAD and VRFs further improved the total predictive capacity (c-statistic 0.669). Conclusions: CCAD and C-IMT are independent predictors of cardiovascular events and together they enhance the predictive capacity of VRFs.File | Dimensione | Formato | |
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