Normative values for carotid intima media thickness and its progression: Are they transferrable outside of their cohort of origin?

Ximing Liao, Giuseppe D. Norata, Joseph F. Polak, Coen D A Stehouwer, Alberico Catapano, Tatjana Rundek, Marat Ezhov, Dirk Sander, Simon G. Thompson, Matthias W. Lorenz, Tatyana Balakhonova, Maya Safarova, Liliana Grigore, Jean Philippe Empana, Hung Ju Lin, Stela McLachlan, Lena Bokemark, Kimmo Ronkainen, Ulf Schminke, Lars LindPeter Willeit, Norbert Yanez, Helmuth Steinmetz, Holger Poppert, Moise Desvarieux, M. Arfan Ikram, Stein Harald Johnsen, Bernhard Iglseder, Alfonsa Friera, Wuxiang Xie, Matthieu Plichart, Ta Chen Su, Sathanur R. Srinivasan, Caroline Schmidt, Tomi Pekka Tuomainen, Henry Völzke, Giel Nijpels, Johann Willeit, Oscar H. Franco, Carmen Suarez, Dong Zhao, Pierre Ducimetiere, Kuo Liong Chien, Christine Robertson, Göran Bergström, Jussi Kauhanen, Marcus Dörr, Jaqueline M. Dekker, Stefan Kiechl, Matthias Sitzer, Horst Bickel, Ralph L. Sacco, Albert Hofman, Ellisiv B. Mathiesen, Rafael Gabriel, Jing Liu, Gerald Berenson, Maryam Kavousi, Jackie F. Price

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background The clinical use of carotid intima media thickness (cIMT) requires normal values, which may be subject to variation of geographical factors, ethnicity or measurement details. The influence of these factors has rarely been studied. The aim of this study was to determine whether normative cIMT values and their association with event risk are generalizable across populations. Design Meta-analysis of individual participant data. Method From 22 general population cohorts from Europe, North America and Asia we selected subjects free of cardiovascular disease. Percentiles of cIMT and cIMT progression were assessed separately for every cohort. Cox proportional hazards models for vascular events were used to estimate hazard ratios for cIMT in each cohort. The estimates were pooled across Europe, North America and Asia, with random effects meta-analysis. The influence of geography, ethnicity and ultrasound protocols on cIMT values and on the hazard ratios was examined by meta-regression. Results Geographical factors, ethnicity and the ultrasound protocol had influence neither on the percentiles of cIMT and its progression, nor on the hazard ratios of cIMT for vascular events. Heterogeneity for percentiles of cIMT and cIMT progression was too large to create meaningful normative values. Conclusions The distribution of cIMT values is too heterogeneous to define universal or regional population reference values. CIMT values vary widely between different studies regardless of ethnicity, geographic location and ultrasound protocol. Prediction of vascular events with cIMT values was more consistent across all cohorts, ethnicities and regions.

Original languageEnglish (US)
Pages (from-to)1165-1173
Number of pages9
JournalEuropean Journal of Preventive Cardiology
Volume23
Issue number11
DOIs
StatePublished - Jul 1 2016
Externally publishedYes

Fingerprint

Carotid Intima-Media Thickness
Northern Asia
Blood Vessels
North America
Meta-Analysis
Reference Values
Population
Geographic Locations
Geography
Proportional Hazards Models
Cardiovascular Diseases

Keywords

  • cardiovascular risk
  • ethnicity
  • geographic
  • hazard ratio
  • Intima media thickness
  • normal value

ASJC Scopus subject areas

  • Epidemiology
  • Cardiology and Cardiovascular Medicine

Cite this

Normative values for carotid intima media thickness and its progression : Are they transferrable outside of their cohort of origin? / Liao, Ximing; Norata, Giuseppe D.; Polak, Joseph F.; Stehouwer, Coen D A; Catapano, Alberico; Rundek, Tatjana; Ezhov, Marat; Sander, Dirk; Thompson, Simon G.; Lorenz, Matthias W.; Balakhonova, Tatyana; Safarova, Maya; Grigore, Liliana; Empana, Jean Philippe; Lin, Hung Ju; McLachlan, Stela; Bokemark, Lena; Ronkainen, Kimmo; Schminke, Ulf; Lind, Lars; Willeit, Peter; Yanez, Norbert; Steinmetz, Helmuth; Poppert, Holger; Desvarieux, Moise; Ikram, M. Arfan; Johnsen, Stein Harald; Iglseder, Bernhard; Friera, Alfonsa; Xie, Wuxiang; Plichart, Matthieu; Su, Ta Chen; Srinivasan, Sathanur R.; Schmidt, Caroline; Tuomainen, Tomi Pekka; Völzke, Henry; Nijpels, Giel; Willeit, Johann; Franco, Oscar H.; Suarez, Carmen; Zhao, Dong; Ducimetiere, Pierre; Chien, Kuo Liong; Robertson, Christine; Bergström, Göran; Kauhanen, Jussi; Dörr, Marcus; Dekker, Jaqueline M.; Kiechl, Stefan; Sitzer, Matthias; Bickel, Horst; Sacco, Ralph L.; Hofman, Albert; Mathiesen, Ellisiv B.; Gabriel, Rafael; Liu, Jing; Berenson, Gerald; Kavousi, Maryam; Price, Jackie F.

In: European Journal of Preventive Cardiology, Vol. 23, No. 11, 01.07.2016, p. 1165-1173.

Research output: Contribution to journalArticle

Liao, X, Norata, GD, Polak, JF, Stehouwer, CDA, Catapano, A, Rundek, T, Ezhov, M, Sander, D, Thompson, SG, Lorenz, MW, Balakhonova, T, Safarova, M, Grigore, L, Empana, JP, Lin, HJ, McLachlan, S, Bokemark, L, Ronkainen, K, Schminke, U, Lind, L, Willeit, P, Yanez, N, Steinmetz, H, Poppert, H, Desvarieux, M, Ikram, MA, Johnsen, SH, Iglseder, B, Friera, A, Xie, W, Plichart, M, Su, TC, Srinivasan, SR, Schmidt, C, Tuomainen, TP, Völzke, H, Nijpels, G, Willeit, J, Franco, OH, Suarez, C, Zhao, D, Ducimetiere, P, Chien, KL, Robertson, C, Bergström, G, Kauhanen, J, Dörr, M, Dekker, JM, Kiechl, S, Sitzer, M, Bickel, H, Sacco, RL, Hofman, A, Mathiesen, EB, Gabriel, R, Liu, J, Berenson, G, Kavousi, M & Price, JF 2016, 'Normative values for carotid intima media thickness and its progression: Are they transferrable outside of their cohort of origin?', European Journal of Preventive Cardiology, vol. 23, no. 11, pp. 1165-1173. https://doi.org/10.1177/2047487315625543
Liao, Ximing ; Norata, Giuseppe D. ; Polak, Joseph F. ; Stehouwer, Coen D A ; Catapano, Alberico ; Rundek, Tatjana ; Ezhov, Marat ; Sander, Dirk ; Thompson, Simon G. ; Lorenz, Matthias W. ; Balakhonova, Tatyana ; Safarova, Maya ; Grigore, Liliana ; Empana, Jean Philippe ; Lin, Hung Ju ; McLachlan, Stela ; Bokemark, Lena ; Ronkainen, Kimmo ; Schminke, Ulf ; Lind, Lars ; Willeit, Peter ; Yanez, Norbert ; Steinmetz, Helmuth ; Poppert, Holger ; Desvarieux, Moise ; Ikram, M. Arfan ; Johnsen, Stein Harald ; Iglseder, Bernhard ; Friera, Alfonsa ; Xie, Wuxiang ; Plichart, Matthieu ; Su, Ta Chen ; Srinivasan, Sathanur R. ; Schmidt, Caroline ; Tuomainen, Tomi Pekka ; Völzke, Henry ; Nijpels, Giel ; Willeit, Johann ; Franco, Oscar H. ; Suarez, Carmen ; Zhao, Dong ; Ducimetiere, Pierre ; Chien, Kuo Liong ; Robertson, Christine ; Bergström, Göran ; Kauhanen, Jussi ; Dörr, Marcus ; Dekker, Jaqueline M. ; Kiechl, Stefan ; Sitzer, Matthias ; Bickel, Horst ; Sacco, Ralph L. ; Hofman, Albert ; Mathiesen, Ellisiv B. ; Gabriel, Rafael ; Liu, Jing ; Berenson, Gerald ; Kavousi, Maryam ; Price, Jackie F. / Normative values for carotid intima media thickness and its progression : Are they transferrable outside of their cohort of origin?. In: European Journal of Preventive Cardiology. 2016 ; Vol. 23, No. 11. pp. 1165-1173.
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title = "Normative values for carotid intima media thickness and its progression: Are they transferrable outside of their cohort of origin?",
abstract = "Background The clinical use of carotid intima media thickness (cIMT) requires normal values, which may be subject to variation of geographical factors, ethnicity or measurement details. The influence of these factors has rarely been studied. The aim of this study was to determine whether normative cIMT values and their association with event risk are generalizable across populations. Design Meta-analysis of individual participant data. Method From 22 general population cohorts from Europe, North America and Asia we selected subjects free of cardiovascular disease. Percentiles of cIMT and cIMT progression were assessed separately for every cohort. Cox proportional hazards models for vascular events were used to estimate hazard ratios for cIMT in each cohort. The estimates were pooled across Europe, North America and Asia, with random effects meta-analysis. The influence of geography, ethnicity and ultrasound protocols on cIMT values and on the hazard ratios was examined by meta-regression. Results Geographical factors, ethnicity and the ultrasound protocol had influence neither on the percentiles of cIMT and its progression, nor on the hazard ratios of cIMT for vascular events. Heterogeneity for percentiles of cIMT and cIMT progression was too large to create meaningful normative values. Conclusions The distribution of cIMT values is too heterogeneous to define universal or regional population reference values. CIMT values vary widely between different studies regardless of ethnicity, geographic location and ultrasound protocol. Prediction of vascular events with cIMT values was more consistent across all cohorts, ethnicities and regions.",
keywords = "cardiovascular risk, ethnicity, geographic, hazard ratio, Intima media thickness, normal value",
author = "Ximing Liao and Norata, {Giuseppe D.} and Polak, {Joseph F.} and Stehouwer, {Coen D A} and Alberico Catapano and Tatjana Rundek and Marat Ezhov and Dirk Sander and Thompson, {Simon G.} and Lorenz, {Matthias W.} and Tatyana Balakhonova and Maya Safarova and Liliana Grigore and Empana, {Jean Philippe} and Lin, {Hung Ju} and Stela McLachlan and Lena Bokemark and Kimmo Ronkainen and Ulf Schminke and Lars Lind and Peter Willeit and Norbert Yanez and Helmuth Steinmetz and Holger Poppert and Moise Desvarieux and Ikram, {M. Arfan} and Johnsen, {Stein Harald} and Bernhard Iglseder and Alfonsa Friera and Wuxiang Xie and Matthieu Plichart and Su, {Ta Chen} and Srinivasan, {Sathanur R.} and Caroline Schmidt and Tuomainen, {Tomi Pekka} and Henry V{\"o}lzke and Giel Nijpels and Johann Willeit and Franco, {Oscar H.} and Carmen Suarez and Dong Zhao and Pierre Ducimetiere and Chien, {Kuo Liong} and Christine Robertson and G{\"o}ran Bergstr{\"o}m and Jussi Kauhanen and Marcus D{\"o}rr and Dekker, {Jaqueline M.} and Stefan Kiechl and Matthias Sitzer and Horst Bickel and Sacco, {Ralph L.} and Albert Hofman and Mathiesen, {Ellisiv B.} and Rafael Gabriel and Jing Liu and Gerald Berenson and Maryam Kavousi and Price, {Jackie F.}",
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TY - JOUR

T1 - Normative values for carotid intima media thickness and its progression

T2 - Are they transferrable outside of their cohort of origin?

AU - Liao, Ximing

AU - Norata, Giuseppe D.

AU - Polak, Joseph F.

AU - Stehouwer, Coen D A

AU - Catapano, Alberico

AU - Rundek, Tatjana

AU - Ezhov, Marat

AU - Sander, Dirk

AU - Thompson, Simon G.

AU - Lorenz, Matthias W.

AU - Balakhonova, Tatyana

AU - Safarova, Maya

AU - Grigore, Liliana

AU - Empana, Jean Philippe

AU - Lin, Hung Ju

AU - McLachlan, Stela

AU - Bokemark, Lena

AU - Ronkainen, Kimmo

AU - Schminke, Ulf

AU - Lind, Lars

AU - Willeit, Peter

AU - Yanez, Norbert

AU - Steinmetz, Helmuth

AU - Poppert, Holger

AU - Desvarieux, Moise

AU - Ikram, M. Arfan

AU - Johnsen, Stein Harald

AU - Iglseder, Bernhard

AU - Friera, Alfonsa

AU - Xie, Wuxiang

AU - Plichart, Matthieu

AU - Su, Ta Chen

AU - Srinivasan, Sathanur R.

AU - Schmidt, Caroline

AU - Tuomainen, Tomi Pekka

AU - Völzke, Henry

AU - Nijpels, Giel

AU - Willeit, Johann

AU - Franco, Oscar H.

AU - Suarez, Carmen

AU - Zhao, Dong

AU - Ducimetiere, Pierre

AU - Chien, Kuo Liong

AU - Robertson, Christine

AU - Bergström, Göran

AU - Kauhanen, Jussi

AU - Dörr, Marcus

AU - Dekker, Jaqueline M.

AU - Kiechl, Stefan

AU - Sitzer, Matthias

AU - Bickel, Horst

AU - Sacco, Ralph L.

AU - Hofman, Albert

AU - Mathiesen, Ellisiv B.

AU - Gabriel, Rafael

AU - Liu, Jing

AU - Berenson, Gerald

AU - Kavousi, Maryam

AU - Price, Jackie F.

PY - 2016/7/1

Y1 - 2016/7/1

N2 - Background The clinical use of carotid intima media thickness (cIMT) requires normal values, which may be subject to variation of geographical factors, ethnicity or measurement details. The influence of these factors has rarely been studied. The aim of this study was to determine whether normative cIMT values and their association with event risk are generalizable across populations. Design Meta-analysis of individual participant data. Method From 22 general population cohorts from Europe, North America and Asia we selected subjects free of cardiovascular disease. Percentiles of cIMT and cIMT progression were assessed separately for every cohort. Cox proportional hazards models for vascular events were used to estimate hazard ratios for cIMT in each cohort. The estimates were pooled across Europe, North America and Asia, with random effects meta-analysis. The influence of geography, ethnicity and ultrasound protocols on cIMT values and on the hazard ratios was examined by meta-regression. Results Geographical factors, ethnicity and the ultrasound protocol had influence neither on the percentiles of cIMT and its progression, nor on the hazard ratios of cIMT for vascular events. Heterogeneity for percentiles of cIMT and cIMT progression was too large to create meaningful normative values. Conclusions The distribution of cIMT values is too heterogeneous to define universal or regional population reference values. CIMT values vary widely between different studies regardless of ethnicity, geographic location and ultrasound protocol. Prediction of vascular events with cIMT values was more consistent across all cohorts, ethnicities and regions.

AB - Background The clinical use of carotid intima media thickness (cIMT) requires normal values, which may be subject to variation of geographical factors, ethnicity or measurement details. The influence of these factors has rarely been studied. The aim of this study was to determine whether normative cIMT values and their association with event risk are generalizable across populations. Design Meta-analysis of individual participant data. Method From 22 general population cohorts from Europe, North America and Asia we selected subjects free of cardiovascular disease. Percentiles of cIMT and cIMT progression were assessed separately for every cohort. Cox proportional hazards models for vascular events were used to estimate hazard ratios for cIMT in each cohort. The estimates were pooled across Europe, North America and Asia, with random effects meta-analysis. The influence of geography, ethnicity and ultrasound protocols on cIMT values and on the hazard ratios was examined by meta-regression. Results Geographical factors, ethnicity and the ultrasound protocol had influence neither on the percentiles of cIMT and its progression, nor on the hazard ratios of cIMT for vascular events. Heterogeneity for percentiles of cIMT and cIMT progression was too large to create meaningful normative values. Conclusions The distribution of cIMT values is too heterogeneous to define universal or regional population reference values. CIMT values vary widely between different studies regardless of ethnicity, geographic location and ultrasound protocol. Prediction of vascular events with cIMT values was more consistent across all cohorts, ethnicities and regions.

KW - cardiovascular risk

KW - ethnicity

KW - geographic

KW - hazard ratio

KW - Intima media thickness

KW - normal value

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