Common carotid intima-media thickness relates to cardiovascular events in adults aged <45 years.
Eikendal ALM., Groenewegen KA., Anderson TJ., Britton AR., Engström G., Evans GW., de Graaf J., Grobbee DE., Hedblad B., Holewijn S., Ikeda A., Kitagawa K., Kitamura A., Lonn EM., Lorenz MW., Mathiesen EB., Nijpels G., Dekker JM., Okazaki S., O'Leary DH., Polak JF., Price JF., Robertson C., Rembold CM., Rosvall M., Rundek T., Salonen JT., Sitzer M., Stehouwer CDA., Hoefer IE., Peters SAE., Bots ML., den Ruijter HM., USE-IMT Project Group None.
Although atherosclerosis starts in early life, evidence on risk factors and atherosclerosis in individuals aged <45 years is scarce. Therefore, we studied the relationship between risk factors, common carotid intima-media thickness (CIMT), and first-time cardiovascular events in adults aged <45 years. Our study population consisted of 3067 adults aged <45 years free from symptomatic cardiovascular disease at baseline, derived from 6 cohorts that are part of the USE-IMT initiative, an individual participant data meta-analysis of general-population-based cohort studies evaluating CIMT measurements. Information on risk factors, CIMT measurements, and follow-up of the combined end point (first-time myocardial infarction or stroke) was obtained. We assessed the relationship between risk factors and CIMT and the relationship between CIMT and first-time myocardial infarction or stroke using a multivariable linear mixed-effects model and a Cox proportional-hazards model, respectively. During a follow-up of 16.3 years, 55 first-time myocardial infarctions or strokes occurred. Median CIMT was 0.63 mm. Of the risk factors under study, age, sex, diastolic blood pressure, body mass index, total cholesterol, and high-density lipoprotein cholesterol related to CIMT. Furthermore, CIMT related to first-time myocardial infarction or stroke with a hazard ratio of 1.40 per SD increase in CIMT, independent of risk factors (95% confidence interval, 1.11-1.76). CIMT may be a valuable marker for cardiovascular risk in adults aged <45 years who are not yet eligible for standard cardiovascular risk screening. This is especially relevant in those with an increased, unfavorable risk factor burden.