Intima-media thickness predicts stroke risk in the Heinz Nixdorf Recall study in association with vascular risk factors, age and gender.
OBJECTIVE
Individual risk stratification requires reliable information on preexisting vascular disease. The intima-media thickness of the common carotid artery (CIMT) is a non-invasively accessible marker of atherosclerosis, which can be used for risk evaluation.


METHODS
In a sample of 3669 initially stroke-free subjects aged 45-75 years belonging to the population-based Heinz Nixdorf Recall cohort, the predictive value of CIMT for incident stroke was evaluated over 85.3 ± 17.4 months in addition to established risk factors.


RESULTS
In a multivariable Cox regression analysis with traditional cardiovascular risk factors including age, gender, systolic blood pressure, LDL and HDL, diabetes, body mass index, smoking and CIMT, CIMT was a moderate stroke predictor (hazard ratio = 1.20 per 0.1 mm, 95% confidence interval = 1.01-1.44; p = 0.043), additional to e.g. age (1.46 per 5 years, 1.21-1.75; p < 0.001), systolic blood pressure (1.16 per 10 mm Hg, 1.04-1.30; p = 0.008) and current smoking (1.93, 1.12-3.31; p = 0.014). CIMT was associated with stroke risk in subjects above but not below 65 years. CIMT predicted stroke events in men, but not women. CIMT discriminated stroke incidence specifically in subjects belonging to the highest Framingham risk score tercile.


CONCLUSIONS
CIMT is a moderate independent stroke predictor, which discriminates stroke incidence in subjects at high vascular risk.
Department of Neurology, University Hospital Essen, Hufelandstr. 55, D-45122 Essen, Germany. dirk.hermann@uk-essen.de
Dirk M
DM
Hermann
Janine
J
Gronewold
Nils
N
Lehmann
Ulla Karen
UK
Seidel
Stefan
S
Möhlenkamp
Christian
C
Weimar
Hagen
H
Kälsch
Susanne
S
Moebus
Karl-Heinz
KH
Jöckel
Raimund
R
Erbel
Marcus
M
Bauer
D000368:Aged; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging; D059168:Carotid Intima-Media Thickness; D015331:Cohort Studies; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012306:Risk; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology / Q000209:etiology*