Carotid intima-media thickness, cardiovascular disease, and risk factors in 29,000 UK Biobank adults
Importance: Atherosclerotic cardiovascular disease remains the leading cause of global morbidity and mortality. Identifying early markers of subclinical atherosclerosis is critical for predicting major adverse cardiovascular events (MACE) and improving prevention strategies. Carotid intima-media thi...
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Elsevier
2025-06-01
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| Series: | American Journal of Preventive Cardiology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666667725000868 |
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| author | Sayan Mitra Raaj Kishore Biswas Petra Hooijenga Sophie Cassidy Andrea Nova Isabella De Ciutiis Tian Wang Cynthia M Kroeger Emmanuel Stamatakis Andrius Masedunskas Raffaele De Caterina Maria L Cagigas Luigi Fontana |
| author_facet | Sayan Mitra Raaj Kishore Biswas Petra Hooijenga Sophie Cassidy Andrea Nova Isabella De Ciutiis Tian Wang Cynthia M Kroeger Emmanuel Stamatakis Andrius Masedunskas Raffaele De Caterina Maria L Cagigas Luigi Fontana |
| author_sort | Sayan Mitra |
| collection | DOAJ |
| description | Importance: Atherosclerotic cardiovascular disease remains the leading cause of global morbidity and mortality. Identifying early markers of subclinical atherosclerosis is critical for predicting major adverse cardiovascular events (MACE) and improving prevention strategies. Carotid intima-media thickness (cIMT) is a well-established surrogate marker of atherosclerosis, but the impact of cardiometabolic risk factor burden on cIMT and future MACE risk is not fully understood. Objective: To assess the association between cIMT and the risk of MACE, and to evaluate the relationship between a composite cardiometabolic-risk biomarker index and cIMT as well as future MACE risk. Design: Prospective cohort study using data from the UK Biobank, with a median follow-up of 4.3 years. Setting: Population-based study of 29,292 participants from the UK Biobank. Participants: Men and women aged 40 to 69 years (n=29,292) free from cardiovascular disease at baseline. Exclusions were made for those with prior coronary heart disease, myocardial infarction, and heart failure. Exposures: Carotid intima-media thickness (cIMT) measured at baseline. A composite cardiometabolic-risk biomarker index (CRBI) was developed using HbA1c, total cholesterol ratio, and blood pressure. Main Outcomes and Measures: The primary outcomes were the risk of MACE, including coronary heart disease (CHD), myocardial infarction (MI), and heart failure (HF). The association between cIMT, CRBI, and the risk of these events was evaluated using hazard ratios (HRs) and adjusted for confounders. Results: Higher cIMT values (>800 µm) were predictive of increased risk for CHD (HR: 2.15 at 800 µm; 95 % CI: 1.07-4.31) and MI (HR: 2.46 at 800 µm; 95 % CI: 0.93-6.53). The cumulative burden of cardiometabolic risk factors, as measured by the CRBI score, was significantly associated with increased cIMT (β=44.38 µm for very high CRBI score; 95 % CI: 38.25-50.51; p < 0.001) and future MI risk (HR: 10.43 for very high CRBI score; 95 % CI: 3.18-34.24). Lifestyle factors such as smoking and physical activity were also correlated with higher cIMT, particularly in males. Conclusions: Carotid intima-media thickness is a strong predictor of coronary heart disease and myocardial infarction. The cumulative cardiometabolic-risk biomarker index offers additional predictive value for subclinical atherosclerosis and future cardiovascular events. These findings underscore the importance of comprehensive cardiometabolic health in CVD prevention strategies. |
| format | Article |
| id | doaj-art-6079590a9a3047bbabdea5c79ffbb495 |
| institution | DOAJ |
| issn | 2666-6677 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Elsevier |
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| series | American Journal of Preventive Cardiology |
| spelling | doaj-art-6079590a9a3047bbabdea5c79ffbb4952025-08-20T03:21:47ZengElsevierAmerican Journal of Preventive Cardiology2666-66772025-06-012210101110.1016/j.ajpc.2025.101011Carotid intima-media thickness, cardiovascular disease, and risk factors in 29,000 UK Biobank adultsSayan Mitra0Raaj Kishore Biswas1Petra Hooijenga2Sophie Cassidy3Andrea Nova4Isabella De Ciutiis5Tian Wang6Cynthia M Kroeger7Emmanuel Stamatakis8Andrius Masedunskas9Raffaele De Caterina10Maria L Cagigas11Luigi Fontana12Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia; Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia; CPC RPA Health for Life Program, Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, AustraliaCharles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia; Mackenzie Wearables Research Hub, Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia; School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, AustraliaCharles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia; Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, AustraliaCharles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia; Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia; CPC RPA Health for Life Program, Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, AustraliaDepartment of Brain and Behavioral Sciences, University of Pavia, 27100, Pavia, ItalyCharles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia; Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia; CPC RPA Health for Life Program, Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, AustraliaCharles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia; Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia; CPC RPA Health for Life Program, Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, AustraliaCharles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia; Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia; CPC RPA Health for Life Program, Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, AustraliaCharles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia; Mackenzie Wearables Research Hub, Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia; School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, AustraliaCharles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia; Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia; CPC RPA Health for Life Program, Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, AustraliaPostgraduate School of Cardiology, Pisa University Hospital, University of PisaCentral Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia; CPC RPA Health for Life Program, Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, AustraliaCharles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia; Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia; CPC RPA Health for Life Program, Charles Perkins Centre, The University of Sydney, Sydney, NSW, 2006, Australia; Department of Endocrinology, Royal Prince Alfred Hospital, Sydney, NSW, 2050, Australia; Corresponding author at: Charles Perkins Centre, John Hopkins Drive, Camperdown, NSW, 2006, AustraliaImportance: Atherosclerotic cardiovascular disease remains the leading cause of global morbidity and mortality. Identifying early markers of subclinical atherosclerosis is critical for predicting major adverse cardiovascular events (MACE) and improving prevention strategies. Carotid intima-media thickness (cIMT) is a well-established surrogate marker of atherosclerosis, but the impact of cardiometabolic risk factor burden on cIMT and future MACE risk is not fully understood. Objective: To assess the association between cIMT and the risk of MACE, and to evaluate the relationship between a composite cardiometabolic-risk biomarker index and cIMT as well as future MACE risk. Design: Prospective cohort study using data from the UK Biobank, with a median follow-up of 4.3 years. Setting: Population-based study of 29,292 participants from the UK Biobank. Participants: Men and women aged 40 to 69 years (n=29,292) free from cardiovascular disease at baseline. Exclusions were made for those with prior coronary heart disease, myocardial infarction, and heart failure. Exposures: Carotid intima-media thickness (cIMT) measured at baseline. A composite cardiometabolic-risk biomarker index (CRBI) was developed using HbA1c, total cholesterol ratio, and blood pressure. Main Outcomes and Measures: The primary outcomes were the risk of MACE, including coronary heart disease (CHD), myocardial infarction (MI), and heart failure (HF). The association between cIMT, CRBI, and the risk of these events was evaluated using hazard ratios (HRs) and adjusted for confounders. Results: Higher cIMT values (>800 µm) were predictive of increased risk for CHD (HR: 2.15 at 800 µm; 95 % CI: 1.07-4.31) and MI (HR: 2.46 at 800 µm; 95 % CI: 0.93-6.53). The cumulative burden of cardiometabolic risk factors, as measured by the CRBI score, was significantly associated with increased cIMT (β=44.38 µm for very high CRBI score; 95 % CI: 38.25-50.51; p < 0.001) and future MI risk (HR: 10.43 for very high CRBI score; 95 % CI: 3.18-34.24). Lifestyle factors such as smoking and physical activity were also correlated with higher cIMT, particularly in males. Conclusions: Carotid intima-media thickness is a strong predictor of coronary heart disease and myocardial infarction. The cumulative cardiometabolic-risk biomarker index offers additional predictive value for subclinical atherosclerosis and future cardiovascular events. These findings underscore the importance of comprehensive cardiometabolic health in CVD prevention strategies.http://www.sciencedirect.com/science/article/pii/S2666667725000868Atherosclerotic cardiovascular diseaseCarotid intima-media thicknessSubclinical atherosclerosisMajor adverse cardiovascular eventsCardiometabolic risk factorCoronary heart disease |
| spellingShingle | Sayan Mitra Raaj Kishore Biswas Petra Hooijenga Sophie Cassidy Andrea Nova Isabella De Ciutiis Tian Wang Cynthia M Kroeger Emmanuel Stamatakis Andrius Masedunskas Raffaele De Caterina Maria L Cagigas Luigi Fontana Carotid intima-media thickness, cardiovascular disease, and risk factors in 29,000 UK Biobank adults American Journal of Preventive Cardiology Atherosclerotic cardiovascular disease Carotid intima-media thickness Subclinical atherosclerosis Major adverse cardiovascular events Cardiometabolic risk factor Coronary heart disease |
| title | Carotid intima-media thickness, cardiovascular disease, and risk factors in 29,000 UK Biobank adults |
| title_full | Carotid intima-media thickness, cardiovascular disease, and risk factors in 29,000 UK Biobank adults |
| title_fullStr | Carotid intima-media thickness, cardiovascular disease, and risk factors in 29,000 UK Biobank adults |
| title_full_unstemmed | Carotid intima-media thickness, cardiovascular disease, and risk factors in 29,000 UK Biobank adults |
| title_short | Carotid intima-media thickness, cardiovascular disease, and risk factors in 29,000 UK Biobank adults |
| title_sort | carotid intima media thickness cardiovascular disease and risk factors in 29 000 uk biobank adults |
| topic | Atherosclerotic cardiovascular disease Carotid intima-media thickness Subclinical atherosclerosis Major adverse cardiovascular events Cardiometabolic risk factor Coronary heart disease |
| url | http://www.sciencedirect.com/science/article/pii/S2666667725000868 |
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