Carotid intima media thickness as marker of atherosclerosis: results of the IMPROVE study

The intima-media thickness (IMT) of carotid arteries, measured by high resolution B-mode ultrasound has been proposed as an useful surrogate marker of atherosclerosis in carotid arteries and in other vascular regions. IMT is a good predictor of new myocardial infarction and it has been shown to be influenced by drugs known to reduce cardiovascular events. In a longitudinal - observational study, we have shown that the integrated use of VRFs included into the Framingham risk score and ultrasonic measurements of carotid IMT significantly increase their capacity to predict cardiovascular events in patients at low/intermediate risk. The integration of carotid IMT with non conventional VRFs (gene polymorphisms. oxidative burden, psyco or socioeconomic aspects etc. ) may further optimize the stratification of patient risk. Another important carotid ultrasonic variable that may have predictive capacity, alone or when integrated with conventional or non conventional risk factors, is the progression of carotid IMT. A prospective, multicenter, longitudinal, long-term, observational study (The IMPROVE study) is currently ongoing. It aims to investigate the capacity of both cross sectional carotid IMT and overall IMT-progression to predict alone, or after integration with both conventional and non conventional VRF, the rate of new vascular events in an European population classified at high risk of cardiovascular disease for the presence of at least 3 VRFs. The patients’ enrolment ended in April 2005 and a total of 3711 patients were recruited in 5 European countries (1095 in ltaly, 504 in France and 2140 in northern Europe). Funding: Supported by European Union (IMPROVE: QLGI-CT-2002- 00896)