title: Carotid intima-media thickness progression predicts cardiovascular events in Japanese patients with type 2 diabetes.
abstract: OBJECTIVE
  The aim of this retrospective study was to investigate the relationship between progression of carotid intima-media thickness (cIMT) and cardiovascular events in Japanese patients with type 2 diabetes mellitus (T2DM) and free of history of cardiovascular events.
  
  
  METHODS
  Patients with T2DM (n=342) without history of cardiovascular events whose cIMT was assessed more than twice by ultrasonography were recruited and followed up for cardiovascular events.
  
  
  RESULTS
  During a mean follow-up of 7.6 years, 56 (16.4%) cardiovascular events (27 coronary events and 29 cerebrovascular events) were recorded. Multivariate analysis with the Cox proportional hazard model identified cIMT progression as a significant determinant of cardiovascular events, with a hazard ratio (HR) of 2.24 (95% confidence interval; CI, 1.25-4.03, P<0.01), in addition to baseline cIMT. The Kaplan-Meier curves also showed significantly higher event rate in patients with high cIMT progression compared with those with low cIMT progression (log-rank χ(2)=6.65; P<0.01). Furthermore, the combination of high baseline cIMT and high cIMT progression was a significant predictor of cardiovascular events.
  
  
  CONCLUSIONS
  Our findings suggest that cIMT progression, in addition to baseline cIMT, is a predictor of cardiovascular events in patients with T2DM without history of cardiovascular events, and that the combination of cIMT progression and baseline cIMT has a strong predictive power for such events.
authors.affiliation: Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan.
authors.forename: Kaede Ishikawa
authors.initials: KI
authors.lastname: Okayama
authors.forename: Tomoya
authors.initials: T
authors.lastname: Mita
authors.forename: Masahiko
authors.initials: M
authors.lastname: Gosho
authors.forename: Risako
authors.initials: R
authors.lastname: Yamamoto
authors.forename: Michiko
authors.initials: M
authors.lastname: Yoshida
authors.forename: Akio
authors.initials: A
authors.lastname: Kanazawa
authors.forename: Ryuzo
authors.initials: R
authors.lastname: Kawamori
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Fujitani
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Watada
mesh_terms: D044466:Asian People; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000209:etiology*; D059168:Carotid Intima-Media Thickness; D002561:Cerebrovascular Disorders / Q000175:diagnosis* / Q000209:etiology*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000503:physiopathology; D006801:Humans; D015999:Multivariate Analysis; D016016:Proportional Hazards Models
keywords: Cardiovascular and cerebrovascular events; Diabetes mellitus; Intima-media thickness