title: Carotid intima-media thickness and risk of cardiovascular events in high-risk patients. Results of the Osaka Follow-Up Study for Carotid Atherosclerosis 2 (OSACA2 Study).
abstract: OBJECTIVE
  There is epidemiological evidence that increased carotid intima-media thickness (IMT) is a predictor of cardiovascular disease (CVD) events. However, the significance of carotid IMT in high-risk patients in whom risk factors are managed clinically has not been adequately investigated. The purpose of this study was to determine the usefulness of carotid IMT measurement in such patients.
  
  
  METHODS
  The study comprised 900 outpatients with cardiovascular risk factors or established atherosclerosis. Carotid IMT was calculated as the mean bilateral IMT of the common carotid artery, bifurcation, and internal carotid artery. Baseline vascular risk factors, medications, and history of CVD were recorded at the time of enrollment. The incidence of CVD events was determined prospectively.
  
  
  RESULTS
  During a mean follow-up period of 2.6 years, there were 64 CVD events. The relative risk (RR) of a CVD event increased with increased IMT. Association between CVD events and carotid IMT was significant after adjustment for risk factors and history of CVD, showing an increased risk per IMT tertile from the middle tertile (RR, 2.5; 95% confidence interval [CI]: 1.0-6.3) to the highest (RR, 3.6; 95% CI: 1.4-9.0). When patients with a history of CVD were excluded (n = 574), the predictive value of IMT was significant even after adjustment for risk factors (hazard ratio per 1 SD IMT increase was 1.57 [95% CI: 1.11-2.20]).
  
  
  CONCLUSIONS
  Carotid IMT is an independent predictor of vascular events in high-risk patients in whom risk factors are managed clinically.
authors.affiliation: Stroke Division, Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Osaka, Japan. kitagawa@medone.med.osaka-u.ac.jp
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kitagawa
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Hougaku
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yamagami
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Hashimoto
authors.forename: Taiji
authors.initials: T
authors.lastname: Itoh
authors.forename: Yoshiomi
authors.initials: Y
authors.lastname: Shimizu
authors.forename: Daisuke
authors.initials: D
authors.lastname: Takahashi
authors.forename: Shinji
authors.initials: S
authors.lastname: Murata
authors.forename: Yujiro
authors.initials: Y
authors.lastname: Seike
authors.forename: Kimito
authors.initials: K
authors.lastname: Kondo
authors.forename: Taku
authors.initials: T
authors.lastname: Hoshi
authors.forename: Shigetaka
authors.initials: S
authors.lastname: Furukado
authors.forename: Yuko
authors.initials: Y
authors.lastname: Abe
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Yagita
authors.forename: Manabu
authors.initials: M
authors.lastname: Sakaguchi
authors.forename: Masafumi
authors.initials: M
authors.lastname: Tagaya
authors.forename: Hideki
authors.initials: H
authors.lastname: Etani
authors.forename: Ryuzo
authors.initials: R
authors.lastname: Fukunaga
authors.forename: Yoji
authors.initials: Y
authors.lastname: Nagai
authors.forename: Masayasu
authors.initials: M
authors.lastname: Matsumoto
authors.forename: Masatsugu
authors.initials: M
authors.lastname: Hori
mesh_terms: D000368:Aged; D050197:Atherosclerosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000401:mortality; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000401:mortality; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging*; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D017539:Tunica Intima / Q000000981:diagnostic imaging*; D017540:Tunica Media / Q000000981:diagnostic imaging*; D014463:Ultrasonography