Carotid Intima-Media thickness progression and risk of vascular events in people with Diabetes: Results from the PROG-IMT collaboration

Matthias W. Lorenz; Jackie F. Price; Christine Robertson; Michiel L. Bots; Joseph F. Polak; Holger Poppert; Maryam Kavousi; Marcus Dorr; Eva Stensland; Pierre Ducimetiere; Kimmo Ronkainen; Stefan Kiechl; Matthias Sitzer; Tatjana Rundek; Lars Lind; Jing Liu; Goran Bergstrom; Liliana Grigore; Lena Bokemark; Alfonsa Friera; David Yanez; Horst Bickel; M. Arfan Ikram; Henry Volzke; Stein Harald Johnsen; Jean Philippe Empana; Tomi Pekka Tuomainen; Peter Willeit; Helmuth Steinmetz; Moise Desvarieux; Wuxiang Xie; Caroline Schmidt; Giuseppe D. Norata; Carmen Suarez; Dirk Sander; Albert Hofman; Ulf Schminke; Ellisiv Mathiesen; Matthieu Plichart; Jussi Kauhanen; Johann Willeit; Ralph L. Sacco; Stela McLachlan; Dong Zhao; Bjorn Fagerberg; Alberico L. Catapano; Rafael Gabriel; Oscar H. Franco; Alpaslan Bulbul; Frank Scheckenbach; Anja Pflug; Lu Gao; Simon G. Thompson

doi:10.2337/dc14-2732

Carotid Intima-Media thickness progression and risk of vascular events in people with Diabetes: Results from the PROG-IMT collaboration

Matthias W. Lorenz, Jackie F. Price, Christine Robertson, Michiel L. Bots, Joseph F. Polak, Holger Poppert, Maryam Kavousi, Marcus Dorr, Eva Stensland, Pierre Ducimetiere, Kimmo Ronkainen, Stefan Kiechl, Matthias Sitzer, Tatjana Rundek, Lars Lind, Jing Liu, Goran Bergstrom, Liliana Grigore, Lena Bokemark, Alfonsa FrieraDavid Yanez, Horst Bickel, M. Arfan Ikram, Henry Volzke, Stein Harald Johnsen, Jean Philippe Empana, Tomi Pekka Tuomainen, Peter Willeit, Helmuth Steinmetz, Moise Desvarieux, Wuxiang Xie, Caroline Schmidt, Giuseppe D. Norata, Carmen Suarez, Dirk Sander, Albert Hofman, Ulf Schminke, Ellisiv Mathiesen, Matthieu Plichart, Jussi Kauhanen, Johann Willeit, Ralph L. Sacco, Stela McLachlan, Dong Zhao, Bjorn Fagerberg, Alberico L. Catapano, Rafael Gabriel, Oscar H. Franco, Alpaslan Bulbul, Frank Scheckenbach, Anja Pflug, Lu Gao, Simon G. Thompson

Research output: Contribution to journal › Article › peer-review

63 Scopus citations

Abstract

OBJECTIVE Carotid intima-media thickness (CIMT) is a marker of subclinical organ damage and predicts cardiovascular disease (CVD) events in the general population. It has also been associated with vascular risk in people with diabetes. However, the association of CIMT change in repeated examinations with subsequent CVD events is uncertain, and its use as a surrogate end point in clinical trials is controversial. We aimed at determining the relation of CIMT change to CVD events in people with diabetes. RESEARCH DESIGN AND METHODS In a comprehensive meta-analysis of individual participant data, we collated data from 3,902 adults (age 33-92 years) with type 2 diabetes from 21 populationbased cohorts. We calculated the hazard ratio (HR) per standard deviation (SD) difference inmean common carotid artery intima-media thickness (CCA-IMT) or in CCA-IMT progression, both calculated from two examinations on average 3.6 years apart, for each cohort, and combined the estimates with random-effects meta-analysis. RESULTS Average mean CCA-IMT ranged from 0.72 to 0.97mmacross cohorts in peoplewith diabetes. The HR of CVD events was 1.22 (95% CI 1.12-1.33) per SD difference in mean CCA-IMT, after adjustment for age, sex, and cardiometabolic risk factors. Average mean CCA-IMT progression in people with diabetes ranged between 20.09 and 0.04 mm/year. The HR per SD difference in mean CCA-IMT progression was 0.99 (0.91-1.08). CONCLUSIONS Despite reproducing the association between CIMT level and vascular risk in subjects with diabetes, we did not find an association between CIMT change and vascular risk. These results do not support the use of CIMT progression as a surrogate end point in clinical trials in people with diabetes.

Original language	English (US)
Pages (from-to)	1921-1929
Number of pages	9
Journal	Diabetes care
Volume	38
Issue number	10
DOIs	https://doi.org/10.2337/dc14-2732
State	Published - Oct 2015
Externally published	Yes

ASJC Scopus subject areas

Internal Medicine
Endocrinology, Diabetes and Metabolism
Advanced and Specialized Nursing

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10.2337/dc14-2732

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Lorenz, M. W., Price, J. F., Robertson, C., Bots, M. L., Polak, J. F., Poppert, H., Kavousi, M., Dorr, M., Stensland, E., Ducimetiere, P., Ronkainen, K., Kiechl, S., Sitzer, M., Rundek, T., Lind, L., Liu, J., Bergstrom, G., Grigore, L., Bokemark, L., ... Thompson, S. G. (2015). Carotid Intima-Media thickness progression and risk of vascular events in people with Diabetes: Results from the PROG-IMT collaboration. Diabetes care, 38(10), 1921-1929. https://doi.org/10.2337/dc14-2732

Lorenz, MW, Price, JF, Robertson, C, Bots, ML, Polak, JF, Poppert, H, Kavousi, M, Dorr, M, Stensland, E, Ducimetiere, P, Ronkainen, K, Kiechl, S, Sitzer, M, Rundek, T, Lind, L, Liu, J, Bergstrom, G, Grigore, L, Bokemark, L, Friera, A, Yanez, D, Bickel, H, Ikram, MA, Volzke, H, Johnsen, SH, Empana, JP, Tuomainen, TP, Willeit, P, Steinmetz, H, Desvarieux, M, Xie, W, Schmidt, C, Norata, GD, Suarez, C, Sander, D, Hofman, A, Schminke, U, Mathiesen, E, Plichart, M, Kauhanen, J, Willeit, J, Sacco, RL, McLachlan, S, Zhao, D, Fagerberg, B, Catapano, AL, Gabriel, R, Franco, OH, Bulbul, A, Scheckenbach, F, Pflug, A, Gao, L & Thompson, SG 2015, 'Carotid Intima-Media thickness progression and risk of vascular events in people with Diabetes: Results from the PROG-IMT collaboration', Diabetes care, vol. 38, no. 10, pp. 1921-1929. https://doi.org/10.2337/dc14-2732

@article{c40f7fd718674b908072b6bc84463627,

title = "Carotid Intima-Media thickness progression and risk of vascular events in people with Diabetes: Results from the PROG-IMT collaboration",

abstract = "OBJECTIVE Carotid intima-media thickness (CIMT) is a marker of subclinical organ damage and predicts cardiovascular disease (CVD) events in the general population. It has also been associated with vascular risk in people with diabetes. However, the association of CIMT change in repeated examinations with subsequent CVD events is uncertain, and its use as a surrogate end point in clinical trials is controversial. We aimed at determining the relation of CIMT change to CVD events in people with diabetes. RESEARCH DESIGN AND METHODS In a comprehensive meta-analysis of individual participant data, we collated data from 3,902 adults (age 33-92 years) with type 2 diabetes from 21 populationbased cohorts. We calculated the hazard ratio (HR) per standard deviation (SD) difference inmean common carotid artery intima-media thickness (CCA-IMT) or in CCA-IMT progression, both calculated from two examinations on average 3.6 years apart, for each cohort, and combined the estimates with random-effects meta-analysis. RESULTS Average mean CCA-IMT ranged from 0.72 to 0.97mmacross cohorts in peoplewith diabetes. The HR of CVD events was 1.22 (95% CI 1.12-1.33) per SD difference in mean CCA-IMT, after adjustment for age, sex, and cardiometabolic risk factors. Average mean CCA-IMT progression in people with diabetes ranged between 20.09 and 0.04 mm/year. The HR per SD difference in mean CCA-IMT progression was 0.99 (0.91-1.08). CONCLUSIONS Despite reproducing the association between CIMT level and vascular risk in subjects with diabetes, we did not find an association between CIMT change and vascular risk. These results do not support the use of CIMT progression as a surrogate end point in clinical trials in people with diabetes.",

author = "Lorenz, {Matthias W.} and Price, {Jackie F.} and Christine Robertson and Bots, {Michiel L.} and Polak, {Joseph F.} and Holger Poppert and Maryam Kavousi and Marcus Dorr and Eva Stensland and Pierre Ducimetiere and Kimmo Ronkainen and Stefan Kiechl and Matthias Sitzer and Tatjana Rundek and Lars Lind and Jing Liu and Goran Bergstrom and Liliana Grigore and Lena Bokemark and Alfonsa Friera and David Yanez and Horst Bickel and Ikram, {M. Arfan} and Henry Volzke and Johnsen, {Stein Harald} and Empana, {Jean Philippe} and Tuomainen, {Tomi Pekka} and Peter Willeit and Helmuth Steinmetz and Moise Desvarieux and Wuxiang Xie and Caroline Schmidt and Norata, {Giuseppe D.} and Carmen Suarez and Dirk Sander and Albert Hofman and Ulf Schminke and Ellisiv Mathiesen and Matthieu Plichart and Jussi Kauhanen and Johann Willeit and Sacco, {Ralph L.} and Stela McLachlan and Dong Zhao and Bjorn Fagerberg and Catapano, {Alberico L.} and Rafael Gabriel and Franco, {Oscar H.} and Alpaslan Bulbul and Frank Scheckenbach and Anja Pflug and Lu Gao and Thompson, {Simon G.}",

note = "Publisher Copyright: {\textcopyright} 2015 by the American Diabetes Association.",

year = "2015",

month = oct,

doi = "10.2337/dc14-2732",

language = "English (US)",

volume = "38",

pages = "1921--1929",

journal = "Diabetes care",

issn = "0149-5992",

publisher = "American Diabetes Association Inc.",

number = "10",

}

TY - JOUR

T1 - Carotid Intima-Media thickness progression and risk of vascular events in people with Diabetes

T2 - Results from the PROG-IMT collaboration

AU - Lorenz, Matthias W.

AU - Price, Jackie F.

AU - Robertson, Christine

AU - Bots, Michiel L.

AU - Polak, Joseph F.

AU - Poppert, Holger

AU - Kavousi, Maryam

AU - Dorr, Marcus

AU - Stensland, Eva

AU - Ducimetiere, Pierre

AU - Ronkainen, Kimmo

AU - Kiechl, Stefan

AU - Sitzer, Matthias

AU - Rundek, Tatjana

AU - Lind, Lars

AU - Liu, Jing

AU - Bergstrom, Goran

AU - Grigore, Liliana

AU - Bokemark, Lena

AU - Friera, Alfonsa

AU - Yanez, David

AU - Bickel, Horst

AU - Ikram, M. Arfan

AU - Volzke, Henry

AU - Johnsen, Stein Harald

AU - Empana, Jean Philippe

AU - Tuomainen, Tomi Pekka

AU - Willeit, Peter

AU - Steinmetz, Helmuth

AU - Desvarieux, Moise

AU - Xie, Wuxiang

AU - Schmidt, Caroline

AU - Norata, Giuseppe D.

AU - Suarez, Carmen

AU - Sander, Dirk

AU - Hofman, Albert

AU - Schminke, Ulf

AU - Mathiesen, Ellisiv

AU - Plichart, Matthieu

AU - Kauhanen, Jussi

AU - Willeit, Johann

AU - Sacco, Ralph L.

AU - McLachlan, Stela

AU - Zhao, Dong

AU - Fagerberg, Bjorn

AU - Catapano, Alberico L.

AU - Gabriel, Rafael

AU - Franco, Oscar H.

AU - Bulbul, Alpaslan

AU - Scheckenbach, Frank

AU - Pflug, Anja

AU - Gao, Lu

AU - Thompson, Simon G.

PY - 2015/10

Y1 - 2015/10

N2 - OBJECTIVE Carotid intima-media thickness (CIMT) is a marker of subclinical organ damage and predicts cardiovascular disease (CVD) events in the general population. It has also been associated with vascular risk in people with diabetes. However, the association of CIMT change in repeated examinations with subsequent CVD events is uncertain, and its use as a surrogate end point in clinical trials is controversial. We aimed at determining the relation of CIMT change to CVD events in people with diabetes. RESEARCH DESIGN AND METHODS In a comprehensive meta-analysis of individual participant data, we collated data from 3,902 adults (age 33-92 years) with type 2 diabetes from 21 populationbased cohorts. We calculated the hazard ratio (HR) per standard deviation (SD) difference inmean common carotid artery intima-media thickness (CCA-IMT) or in CCA-IMT progression, both calculated from two examinations on average 3.6 years apart, for each cohort, and combined the estimates with random-effects meta-analysis. RESULTS Average mean CCA-IMT ranged from 0.72 to 0.97mmacross cohorts in peoplewith diabetes. The HR of CVD events was 1.22 (95% CI 1.12-1.33) per SD difference in mean CCA-IMT, after adjustment for age, sex, and cardiometabolic risk factors. Average mean CCA-IMT progression in people with diabetes ranged between 20.09 and 0.04 mm/year. The HR per SD difference in mean CCA-IMT progression was 0.99 (0.91-1.08). CONCLUSIONS Despite reproducing the association between CIMT level and vascular risk in subjects with diabetes, we did not find an association between CIMT change and vascular risk. These results do not support the use of CIMT progression as a surrogate end point in clinical trials in people with diabetes.

AB - OBJECTIVE Carotid intima-media thickness (CIMT) is a marker of subclinical organ damage and predicts cardiovascular disease (CVD) events in the general population. It has also been associated with vascular risk in people with diabetes. However, the association of CIMT change in repeated examinations with subsequent CVD events is uncertain, and its use as a surrogate end point in clinical trials is controversial. We aimed at determining the relation of CIMT change to CVD events in people with diabetes. RESEARCH DESIGN AND METHODS In a comprehensive meta-analysis of individual participant data, we collated data from 3,902 adults (age 33-92 years) with type 2 diabetes from 21 populationbased cohorts. We calculated the hazard ratio (HR) per standard deviation (SD) difference inmean common carotid artery intima-media thickness (CCA-IMT) or in CCA-IMT progression, both calculated from two examinations on average 3.6 years apart, for each cohort, and combined the estimates with random-effects meta-analysis. RESULTS Average mean CCA-IMT ranged from 0.72 to 0.97mmacross cohorts in peoplewith diabetes. The HR of CVD events was 1.22 (95% CI 1.12-1.33) per SD difference in mean CCA-IMT, after adjustment for age, sex, and cardiometabolic risk factors. Average mean CCA-IMT progression in people with diabetes ranged between 20.09 and 0.04 mm/year. The HR per SD difference in mean CCA-IMT progression was 0.99 (0.91-1.08). CONCLUSIONS Despite reproducing the association between CIMT level and vascular risk in subjects with diabetes, we did not find an association between CIMT change and vascular risk. These results do not support the use of CIMT progression as a surrogate end point in clinical trials in people with diabetes.

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SN - 0149-5992

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SP - 1921

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JO - Diabetes care

JF - Diabetes care

IS - 10

ER -

Carotid Intima-Media thickness progression and risk of vascular events in people with Diabetes: Results from the PROG-IMT collaboration

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