Predictive value for cardiovascular events of common carotid intima media thickness and its rate of change in individuals at high cardiovascular risk – Results from the PROG-IMT collaboration

Research output: Contribution to journalArticle


Aims Carotid intima media thickness (CIMT) predicts cardiovascular (CVD) events, but the predictive value of CIMT change is debated. We assessed the relation between CIMT change and events in individuals at high cardiovascular risk. Methods and results From 31 cohorts with two CIMT scans (total n = 89070) on average 3.6 years apart and clinical follow-up, subcohorts were drawn: (A) individuals with at least 3 cardiovascular risk factors without previous CVD events, (B) individuals with carotid plaques without previous CVD events, and (C) individuals with previous CVD events. Cox regression models were fit to estimate the hazard ratio (HR) of the combined endpoint (myocardial infarction, stroke or vascular death) per standard deviation (SD) of CIMT change, adjusted for CVD risk factors. These HRs were pooled across studies. In groups A, B and C we observed 3483, 2845 and 1165 endpoint events, respectively. Average common CIMT was 0.79mm (SD 0.16mm), and annual common CIMT change was 0.01mm (SD 0.07mm), both in group A. The pooled HR per SD of annual common CIMT change (0.02 to 0.43mm) was 0.99 (95% confidence interval: 0.95–1.02) in group A, 0.98 (0.93–1.04) in group B, and 0.95 (0.89–1.04) in group C. The HR per SD of common CIMT (average of the first and the second CIMT scan, 0.09 to 0.75mm) was 1.15 (1.07–1.23) in group A, 1.13 (1.05–1.22) in group B, and 1.12 (1.05–1.20) in group C. Conclusions We confirm that common CIMT is associated with future CVD events in individuals at high risk. CIMT change does not relate to future event risk in high-risk individuals.


  • Matthias W. Lorenz
  • Lu Gao
  • Kathrin Ziegelbauer
  • Giuseppe Danilo Norata
  • Jean Philippe Empana
  • Irene Schmidtmann
  • Hung Ju Lin
  • Stela McLachlan
  • Lena Bokemark
  • Kimmo Ronkainen
  • Mauro Amato
  • Ulf Schminke
  • Sathanur R. Srinivasan
  • Lars Lind
  • Shuhei Okazaki
  • Coen D.A. Stehouwer
  • Peter Willeit
  • Joseph F. Polak
  • Helmuth Steinmetz
  • Dirk Sander
  • Holger Poppert
  • Moise Desvarieux
  • M. Arfan Ikram
  • Stein Harald Johnsen
  • Daniel Staub
  • Cesare R. Sirtori
  • Bernhard Iglseder
  • Oscar Beloqui
  • Gunnar Engström
  • Alfonso Friera
  • Francesco Rozza
  • Wuxiang Xie
  • Grace Parraga
  • Liliana Grigore
  • Matthieu Plichart
  • Stefan Blankenberg
  • Ta Chen Su
  • Caroline Schmidt
  • Tomi Pekka Tuomainen
  • Fabrizio Veglia
  • Henry Völzke
  • Giel Nijpels
  • Johann Willeit
  • Ralph L. Sacco
  • Oscar H. Franco
  • Heiko Uthoff
  • Bo Hedblad
  • Carmen Suarez
  • Raffaele Izzo
  • Maria Rosvall
  • PROG-IMT study group
External organisations
  • Goethe University
  • Paris Descartes University
  • University Hospital Greifswald
  • Tulane University
  • Uppsala University
  • Osaka University
  • Maastricht University
  • Tufts University School of Medicine
  • Columbia University
  • University Hospital Basel
  • University Medical Center Hamburg-Eppendorf
  • German Centre for Cardiovascular Research
  • Bassini Hospital
  • Universitätsmedizin Mainz
  • National Taiwan University Hospital
  • Benedictus Hospital Tutzing
  • University Hospital of North Norway
  • Paracelsus Private Medical University of Salzburg
  • Autonomous University of Madrid
  • Hôpital Broca, Paris
  • University of Cambridge
  • University of Milan
  • University of Edinburgh
  • University of Gothenburg
  • University of Eastern Finland
  • Centro Cardiologico Monzino
  • Medical University of Innsbruck
  • Technical University of Munich
  • Erasmus University Medical Center
  • UiT The Arctic University of Norway, Tromsø
  • Niguarda Hospital
  • University Clinic of Navarra
  • University of Naples Federico II
  • Capital University of Medical Sciences
  • University of Western Ontario
  • University of Mainz
  • Amsterdam UMC - Vrije Universiteit Amsterdam
  • University of Miami
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Cardiac and Cardiovascular Systems
Original languageEnglish
Article numbere0191172
JournalPLoS ONE
Issue number4
Publication statusPublished - 2018 Apr 1
Publication categoryResearch