Association between the intima-media thickness of the common carotid and subsequent cardiovascular events in subjects, 55 years and older, in the Rotterdam study (ERGO)
Bots, M.L.; Hoes, A.W.; Koudstaal, P.J.; Hofman, A.; Witteman, J.C.; Grobbee, D.E.
Nederlands Tijdschrift Voor Geneeskunde 142(19): 1100-1103
1998
ISSN/ISBN: 0028-2162 PMID: 9623228 Document Number: 486287
To determine whether common carotid artery intima-media thickness (IMT) is related to future cardiovascular disease. Nested case control study. The suburb of Ommoord in Rotterdam, the Netherlands. As part of the Rotterdam study among 7983 subjects aged 55 years and over, ultrasound images of the common carotid artery were stored on videotape of 5965 subjects at baseline (1990-1993). Analysis (logistic regression) was based on 190 cases of cardiovascular disease (myocardial infarction and stroke), registered up to December 31, 1994. IMT was measured from videotape for all cases and a control sample of 1373 subjects who remained free from myocardial infarction and stroke during follow-up. The mean duration of follow-up was 2.7 years. The age and sex adjusted cardiovascular disease risk increased by 45% (95% confidence interval (95% CI): 25-69) per standard deviation increase (0.163 mm) in IMT. Stroke risk increased by 45% (95% CI: 25-69) per standard deviation increase and the risk of myocardial infarction increased by 43% (95% CI: 16-78). Additional adjustment for several cardiovascular risk factors attenuated the association. Increased common carotid intima-media thickness was associated with subsequent cardiovascular events. These results support the use of carotid intima-media thickness measurements as a surrogate endpoint in observation and intervention studies. The value of IMT measurements for individual patients and cardiovascular screening merits further study.