Enhancing Cardiovascular Risk Prediction with a Simplified Carotid IMT Protocol: Evidence from the IMPROVE Study
<b>Background/Objectives</b>: Carotid intima-media thickness (CIMT) has long been used as an index of subclinical atherosclerosis, but its role as a risk modifier in cardiovascular (CV) risk optimization has recently been questioned due to methodological problems, such as lack of protoco...
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2025-02-01
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| author | Fabrizio Veglia Anna Maria Malagoni Mauro Amato Rona J. Strawbridge Kai Savonen Philippe Giral Antonio Gallo Matteo Pirro Bruna Gigante Per Eriksson Douwe J. Mulder Beatrice Frigerio Daniela Sansaro Alessio Ravani Daniela Coggi Roberta Baetta Nicolò Capra Elena Tremoli Damiano Baldassarre |
| author_facet | Fabrizio Veglia Anna Maria Malagoni Mauro Amato Rona J. Strawbridge Kai Savonen Philippe Giral Antonio Gallo Matteo Pirro Bruna Gigante Per Eriksson Douwe J. Mulder Beatrice Frigerio Daniela Sansaro Alessio Ravani Daniela Coggi Roberta Baetta Nicolò Capra Elena Tremoli Damiano Baldassarre |
| author_sort | Fabrizio Veglia |
| collection | DOAJ |
| description | <b>Background/Objectives</b>: Carotid intima-media thickness (CIMT) has long been used as an index of subclinical atherosclerosis, but its role as a risk modifier in cardiovascular (CV) risk optimization has recently been questioned due to methodological problems, such as lack of protocol standardization and scanning difficulties. In this multicentre, longitudinal, and observational study, we tested the predictive ability of two new CIMT variables detectable with a simplified, quick, and easy-to-standardize protocol. <b>Methods</b>: CIMT was measured in 3165 subjects from six centers, in five European countries, belonging to the IMPROVE study. The two variables tested were the average of two maximal CIMT measures taken, from a single angle, in the right and left common carotids (1CC-IMT<sub>mean-of-2-max</sub>) or bifurcations (BIF-IMT<sub>mean-of-2-max</sub>). The ability to predict CV events, on top of the SCORE2/SCORE2-OP risk algorithm, was quantified by the time-dependent increase in the receiver operating characteristic (ROC) area under the curve (AUC). <b>Results</b>: During a median follow-up of 7.1 years, 367 cardio-, cerebro-, and peripheral-vascular events were registered. Both CIMT variables tested were associated with CV risk, but 1CC-IMT<sub>mean-of-2-max</sub> was also able to significantly increase the ROC AUC over the risk score (+0.017, <i>p</i> = 0.014). The result was stable after running several sensitivity analyses. <b>Conclusions</b>: 1CC-IMT<sub>mean-of-2-max</sub> is able to significantly improve the predictive capacity of SCORE2/SCORE2-OP. Being based on a simple and easily standardized measurement protocol, this new variable is a promising candidate for application in mass screening and risk assessment in primary prevention. |
| format | Article |
| id | doaj-art-d1f7952a100f44969151d4ae08ef3c50 |
| institution | DOAJ |
| issn | 2227-9059 |
| language | English |
| publishDate | 2025-02-01 |
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| series | Biomedicines |
| spelling | doaj-art-d1f7952a100f44969151d4ae08ef3c502025-08-20T02:42:41ZengMDPI AGBiomedicines2227-90592025-02-0113358410.3390/biomedicines13030584Enhancing Cardiovascular Risk Prediction with a Simplified Carotid IMT Protocol: Evidence from the IMPROVE StudyFabrizio Veglia0Anna Maria Malagoni1Mauro Amato2Rona J. Strawbridge3Kai Savonen4Philippe Giral5Antonio Gallo6Matteo Pirro7Bruna Gigante8Per Eriksson9Douwe J. Mulder10Beatrice Frigerio11Daniela Sansaro12Alessio Ravani13Daniela Coggi14Roberta Baetta15Nicolò Capra16Elena Tremoli17Damiano Baldassarre18Maria Cecilia Hospital, GVM Care & Research, 48033 Cotignola, ItalyMaria Cecilia Hospital, GVM Care & Research, 48033 Cotignola, ItalyCentro Cardiologico Monzino IRCCS, 20138 Milan, ItalyDepartment of Medicine Solna, Division of Cardiovascular Medicine, Karolinska Institutet, Stockholm, Karolinska University Hospital, 17177 Solna, SwedenFoundation for Research in Health Exercise and Nutrition, Kuopio Research Institute of Exercise Medicine, 70100 Kuopio, FinlandINSERM, Unité de Recherche sur les Maladies Cardiovasculaires, le Métabolisme et la Nutrition, ICAN, Sorbonne Université, F-75013 Paris, FranceINSERM, Unité de Recherche sur les Maladies Cardiovasculaires, le Métabolisme et la Nutrition, ICAN, Sorbonne Université, F-75013 Paris, FranceInternal Medicine, Angiology and Arteriosclerosis Diseases, Department of Medicine and Surgery, University of Perugia, 06129 Perugia, ItalyDepartment of Medicine Solna, Division of Cardiovascular Medicine, Karolinska Institutet, Stockholm, Karolinska University Hospital, 17177 Solna, SwedenDepartment of Medicine Solna, Division of Cardiovascular Medicine, Karolinska Institutet, Stockholm, Karolinska University Hospital, 17177 Solna, SwedenDepartment of Internal Medicine, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The NetherlandsCentro Cardiologico Monzino IRCCS, 20138 Milan, ItalyCentro Cardiologico Monzino IRCCS, 20138 Milan, ItalyCentro Cardiologico Monzino IRCCS, 20138 Milan, ItalyCentro Cardiologico Monzino IRCCS, 20138 Milan, ItalyCentro Cardiologico Monzino IRCCS, 20138 Milan, ItalyCentro Cardiologico Monzino IRCCS, 20138 Milan, ItalyMaria Cecilia Hospital, GVM Care & Research, 48033 Cotignola, ItalyCentro Cardiologico Monzino IRCCS, 20138 Milan, Italy<b>Background/Objectives</b>: Carotid intima-media thickness (CIMT) has long been used as an index of subclinical atherosclerosis, but its role as a risk modifier in cardiovascular (CV) risk optimization has recently been questioned due to methodological problems, such as lack of protocol standardization and scanning difficulties. In this multicentre, longitudinal, and observational study, we tested the predictive ability of two new CIMT variables detectable with a simplified, quick, and easy-to-standardize protocol. <b>Methods</b>: CIMT was measured in 3165 subjects from six centers, in five European countries, belonging to the IMPROVE study. The two variables tested were the average of two maximal CIMT measures taken, from a single angle, in the right and left common carotids (1CC-IMT<sub>mean-of-2-max</sub>) or bifurcations (BIF-IMT<sub>mean-of-2-max</sub>). The ability to predict CV events, on top of the SCORE2/SCORE2-OP risk algorithm, was quantified by the time-dependent increase in the receiver operating characteristic (ROC) area under the curve (AUC). <b>Results</b>: During a median follow-up of 7.1 years, 367 cardio-, cerebro-, and peripheral-vascular events were registered. Both CIMT variables tested were associated with CV risk, but 1CC-IMT<sub>mean-of-2-max</sub> was also able to significantly increase the ROC AUC over the risk score (+0.017, <i>p</i> = 0.014). The result was stable after running several sensitivity analyses. <b>Conclusions</b>: 1CC-IMT<sub>mean-of-2-max</sub> is able to significantly improve the predictive capacity of SCORE2/SCORE2-OP. Being based on a simple and easily standardized measurement protocol, this new variable is a promising candidate for application in mass screening and risk assessment in primary prevention.https://www.mdpi.com/2227-9059/13/3/584carotid arteryintima-media thicknessplaqueultrasonography protocolIMPROVE study |
| spellingShingle | Fabrizio Veglia Anna Maria Malagoni Mauro Amato Rona J. Strawbridge Kai Savonen Philippe Giral Antonio Gallo Matteo Pirro Bruna Gigante Per Eriksson Douwe J. Mulder Beatrice Frigerio Daniela Sansaro Alessio Ravani Daniela Coggi Roberta Baetta Nicolò Capra Elena Tremoli Damiano Baldassarre Enhancing Cardiovascular Risk Prediction with a Simplified Carotid IMT Protocol: Evidence from the IMPROVE Study Biomedicines carotid artery intima-media thickness plaque ultrasonography protocol IMPROVE study |
| title | Enhancing Cardiovascular Risk Prediction with a Simplified Carotid IMT Protocol: Evidence from the IMPROVE Study |
| title_full | Enhancing Cardiovascular Risk Prediction with a Simplified Carotid IMT Protocol: Evidence from the IMPROVE Study |
| title_fullStr | Enhancing Cardiovascular Risk Prediction with a Simplified Carotid IMT Protocol: Evidence from the IMPROVE Study |
| title_full_unstemmed | Enhancing Cardiovascular Risk Prediction with a Simplified Carotid IMT Protocol: Evidence from the IMPROVE Study |
| title_short | Enhancing Cardiovascular Risk Prediction with a Simplified Carotid IMT Protocol: Evidence from the IMPROVE Study |
| title_sort | enhancing cardiovascular risk prediction with a simplified carotid imt protocol evidence from the improve study |
| topic | carotid artery intima-media thickness plaque ultrasonography protocol IMPROVE study |
| url | https://www.mdpi.com/2227-9059/13/3/584 |
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