title: Carotid intima-media thickness for cardiovascular risk assessment: systematic review and meta-analysis.
abstract: OBJECTIVE
  B-mode ultrasound measurement of the carotid intima-media thickness (CIMT) is a widely used marker for atherosclerosis and is associated with future cardiovascular events. This article provides a review and meta-analysis of the published evidence on the association of CIMT with future cardiovascular events and its additional value to traditional cardiovascular risk prediction models.
  
  
  METHODS
  A systematic review and meta-analysis of the evidence on the association of CIMT with future cardiovascular events and the additional value of CIMT to traditional cardiovascular risk prediction models was conducted. The association of CIMT with future cardiovascular events and the additional value of CIMT were calculated using random effects analysis.
  
  
  RESULTS
  The literature search yielded 1196 articles of which 15 articles provided sufficient data for the meta-analysis. A 1 SD increase in CIMT was predictive for myocardial infarction (HR 1.26, 95% CI 1.20-1.31) and for stroke (HR 1.31, 95% CI 1.26-1.36). A 0.1 mm increase in CIMT was predictive for myocardial infarction (HR 1.15, 95% CI 1.12-1.18) and for stroke (HR 1.17, 95% CI 1.15-1.21). The overall performance of risk prediction models did not significantly increase after addition of CIMT data. The areas under the curve increased from 0.726 to 0.729 (p = 0.8).
  
  
  CONCLUSIONS
  CIMT as measured by B-mode ultrasound is associated with future cardiovascular events. However, the addition of CIMT to traditional cardiovascular risk prediction models does not lead to a statistical significantly increase in performance of those models.
authors: Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands.
authors: Stijn C H
authors: SC
authors: van den Oord
authors: Eric J G
authors: EJ
authors: Sijbrands
authors: Gerrit L
authors: GL
authors: ten Kate
authors: David
authors: D
authors: van Klaveren
authors: Ron T
authors: RT
authors: van Domburg
authors: Antonius F W
authors: AF
authors: van der Steen
authors: Arend F L
authors: AF
authors: Schinkel
mesh_terms: D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D059168:Carotid Intima-Media Thickness; D006801:Humans; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors