The intima-media thickness (IMT) of extracranial carotid arteries, measured by high-resolution B-mode ultrasound, has been widely used to investigate the effects of conventional and non-conventional vascular risk factors as well as its association with end-organ damage of high-risk patients. In view of its correlation with coronary atherosclerosis carotid IMT has been proposed as an useful surrogate atherosclerotic marker of other vascular regions. Studies have supported its nature of surrogate marker showing that IMT is a good predictor of new myocardial infarction. Generally, attempts to delay IMT-progression using "anti-atherosclerotic" agents have provided encouraging results; a variety of drugs with different mechanism of action, have been shown, indeed, to reduce C-IMT progression. In some studies the pharmacologically-induced changes in C-IMT have been even associated with a concomitant reduction of cardiovascular events, which further supports the concept that IMT can be considered as a surrogate index of coronary atherosclerosis. No one of the studies published so far has, however, been able to address, on a prospective basis, whether IMT-progression, that is the end point of pharmacological studies, may effectively predicts the occurrence of cardiovascular events. To address these issues we designed “the IMPROVE study”, a currently on going prospective multicenter, longitudinal, long-term, observational study funded by the European Community. The major objective of the IMPROVE study is to evaluate the association between IMT, IMT-progression and the rate of new vascular events in an European population of patients at high risk of atherosclerosis for the presence of at least three vascular risk factors. The design of the study foresees also the evaluation of the effect of gene polymorphisms, lipid peroxidation, socio-economic and psychological variables on the same ultrasonic end points. In order to achieve the project objectives, 3711 patients have been recruited in 7 European countries. The patient recruitment ended in June 2005 and the final results are expected by the end of 2008. Patients, in fact, had to be followed ultrasonically and clinically for 30 months and clinical events have to be monitored up to 36 months. Data will be analysed with conventional statistics and with innovative approaches based on artificial neural networks. The study will be considered as positive if a difference of at least 3% in the cumulative incidence of acute vascular events between the lowest and the highest quintiles of IMT and, overall, of IMT-progression will be detected. A summary of aims, design and baseline results of the study will be presented.

Carotid intima media thickness (IMT) and IMT-progression as predictors of vascular events in a high risk European population: the Improve study / E. Tremoli, D. Baldassarre. - In: ATHEROSCLEROSIS SUPPLEMENTS. - ISSN 1567-5688. - 7:3(2006), pp. 42-42. (Intervento presentato al 14. convegno International-Society-of-Atherosclerosis tenutosi a Roma nel 2006) [10.1016/S1567-5688(06)80130-3].

Carotid intima media thickness (IMT) and IMT-progression as predictors of vascular events in a high risk European population: the Improve study

E. Tremoli
Primo
;
D. Baldassarre
Ultimo
2006

Abstract

The intima-media thickness (IMT) of extracranial carotid arteries, measured by high-resolution B-mode ultrasound, has been widely used to investigate the effects of conventional and non-conventional vascular risk factors as well as its association with end-organ damage of high-risk patients. In view of its correlation with coronary atherosclerosis carotid IMT has been proposed as an useful surrogate atherosclerotic marker of other vascular regions. Studies have supported its nature of surrogate marker showing that IMT is a good predictor of new myocardial infarction. Generally, attempts to delay IMT-progression using "anti-atherosclerotic" agents have provided encouraging results; a variety of drugs with different mechanism of action, have been shown, indeed, to reduce C-IMT progression. In some studies the pharmacologically-induced changes in C-IMT have been even associated with a concomitant reduction of cardiovascular events, which further supports the concept that IMT can be considered as a surrogate index of coronary atherosclerosis. No one of the studies published so far has, however, been able to address, on a prospective basis, whether IMT-progression, that is the end point of pharmacological studies, may effectively predicts the occurrence of cardiovascular events. To address these issues we designed “the IMPROVE study”, a currently on going prospective multicenter, longitudinal, long-term, observational study funded by the European Community. The major objective of the IMPROVE study is to evaluate the association between IMT, IMT-progression and the rate of new vascular events in an European population of patients at high risk of atherosclerosis for the presence of at least three vascular risk factors. The design of the study foresees also the evaluation of the effect of gene polymorphisms, lipid peroxidation, socio-economic and psychological variables on the same ultrasonic end points. In order to achieve the project objectives, 3711 patients have been recruited in 7 European countries. The patient recruitment ended in June 2005 and the final results are expected by the end of 2008. Patients, in fact, had to be followed ultrasonically and clinically for 30 months and clinical events have to be monitored up to 36 months. Data will be analysed with conventional statistics and with innovative approaches based on artificial neural networks. The study will be considered as positive if a difference of at least 3% in the cumulative incidence of acute vascular events between the lowest and the highest quintiles of IMT and, overall, of IMT-progression will be detected. A summary of aims, design and baseline results of the study will be presented.
biomarkers, b-mode ultrasound, risk factors, atherosclerosis, intima media thickness
Settore BIO/14 - Farmacologia
2006
Article (author)
File in questo prodotto:
File Dimensione Formato  
001 tremoli.PDF

accesso riservato

Tipologia: Publisher's version/PDF
Dimensione 5.47 MB
Formato Adobe PDF
5.47 MB Adobe PDF   Visualizza/Apri   Richiedi una copia
Pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/69615
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus ND
  • ???jsp.display-item.citation.isi??? 0
social impact