Clinical and therapeutic value of carotid intima-media thickness
Carotid Intima Media Thickness (IMT) has been widely used to predict cardiovascular events in primary and secondary prevention studies. Yet, the power of IMT to reclassify risk level on top of conventional risk assessment based on classical risk factors remains unsettled. In fact, recent data indica...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
Enrico Vassallo [verfasserIn] Francesca Musella [verfasserIn] Susanna Mosca [verfasserIn] Laura Casaretti [verfasserIn] Roberto Formisano [verfasserIn] Giacomo Mattiello [verfasserIn] Ada Bologna [verfasserIn] Irma Fabiani [verfasserIn] Francesco Gambardella [verfasserIn] Laura Petraglia [verfasserIn] Giuseppe Rengo [verfasserIn] Dario Leosco [verfasserIn] Pasquale Perrone-Filardi [verfasserIn] |
|---|
| Format: |
E-Artikel |
|---|---|
| Sprache: |
Englisch |
| Erschienen: |
2015 |
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| Schlagwörter: |
Carotid Intima Media Thickness |
|---|
| Übergeordnetes Werk: |
In: Monaldi Archives for Chest Disease - PAGEPress Publications, 2019, 76(2015), 3 |
|---|---|
| Übergeordnetes Werk: |
volume:76 ; year:2015 ; number:3 |
| Links: |
Link aufrufen |
|---|
| DOI / URN: |
10.4081/monaldi.2011.184 |
|---|
| Katalog-ID: |
DOAJ006769705 |
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| 520 | |a Carotid Intima Media Thickness (IMT) has been widely used to predict cardiovascular events in primary and secondary prevention studies. Yet, the power of IMT to reclassify risk level on top of conventional risk assessment based on classical risk factors remains unsettled. In fact, recent data indicate that the prognostic power of IMT is lower than that provided by the identification of carotid plaques. The role of IMT as surrogate endpoint to assess the efficacy of cardiovascular protective therapies is also still debated. In fact, no studies have ever been designed and powered to show a relationship between changes in carotid IMT during follow-up and cardiovascular events. Recently, two metaanalysis of trials using IMT as surrogate endpoint failed to demonstrate an association between IMT regression and cardiovascular events. The reasons for the lack of predictive role for changes in IMT are uncertain. It has been shown that IMT is not a pure atherosclerotic index, being substantially affected by age and hemodynamic factors including blood pressure and vessel wall shear stress. In addition, the status of carotid vessels does not strictly reflect that of coronary arteries. Finally, intra and inter-observer variability of measurements may further limit the association between IMT changes in individual patients and cardiovascular risk. Thus, IMT represents a valuable risk marker in population studies but its role for tailoring cardiovascular therapy in clinical practice remains currently uncertain. | ||
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10.4081/monaldi.2011.184 doi (DE-627)DOAJ006769705 (DE-599)DOAJa980aad72661462192e086498dd834ed DE-627 ger DE-627 rakwb eng Enrico Vassallo verfasserin aut Clinical and therapeutic value of carotid intima-media thickness 2015 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Carotid Intima Media Thickness (IMT) has been widely used to predict cardiovascular events in primary and secondary prevention studies. Yet, the power of IMT to reclassify risk level on top of conventional risk assessment based on classical risk factors remains unsettled. In fact, recent data indicate that the prognostic power of IMT is lower than that provided by the identification of carotid plaques. The role of IMT as surrogate endpoint to assess the efficacy of cardiovascular protective therapies is also still debated. In fact, no studies have ever been designed and powered to show a relationship between changes in carotid IMT during follow-up and cardiovascular events. Recently, two metaanalysis of trials using IMT as surrogate endpoint failed to demonstrate an association between IMT regression and cardiovascular events. The reasons for the lack of predictive role for changes in IMT are uncertain. It has been shown that IMT is not a pure atherosclerotic index, being substantially affected by age and hemodynamic factors including blood pressure and vessel wall shear stress. In addition, the status of carotid vessels does not strictly reflect that of coronary arteries. Finally, intra and inter-observer variability of measurements may further limit the association between IMT changes in individual patients and cardiovascular risk. Thus, IMT represents a valuable risk marker in population studies but its role for tailoring cardiovascular therapy in clinical practice remains currently uncertain. Carotid Intima Media Thickness Cardiovascular risk prediction cardiovascular prevention. Medicine R Francesca Musella verfasserin aut Susanna Mosca verfasserin aut Laura Casaretti verfasserin aut Roberto Formisano verfasserin aut Giacomo Mattiello verfasserin aut Ada Bologna verfasserin aut Irma Fabiani verfasserin aut Francesco Gambardella verfasserin aut Laura Petraglia verfasserin aut Giuseppe Rengo verfasserin aut Dario Leosco verfasserin aut Pasquale Perrone-Filardi verfasserin aut In Monaldi Archives for Chest Disease PAGEPress Publications, 2019 76(2015), 3 (DE-627)537441069 (DE-600)2375904-5 25325264 nnns volume:76 year:2015 number:3 https://doi.org/10.4081/monaldi.2011.184 kostenfrei https://doaj.org/article/a980aad72661462192e086498dd834ed kostenfrei https://www.monaldi-archives.org/index.php/macd/article/view/184 kostenfrei https://doaj.org/toc/1122-0643 Journal toc kostenfrei https://doaj.org/toc/2532-5264 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 76 2015 3 |
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10.4081/monaldi.2011.184 doi (DE-627)DOAJ006769705 (DE-599)DOAJa980aad72661462192e086498dd834ed DE-627 ger DE-627 rakwb eng Enrico Vassallo verfasserin aut Clinical and therapeutic value of carotid intima-media thickness 2015 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Carotid Intima Media Thickness (IMT) has been widely used to predict cardiovascular events in primary and secondary prevention studies. Yet, the power of IMT to reclassify risk level on top of conventional risk assessment based on classical risk factors remains unsettled. In fact, recent data indicate that the prognostic power of IMT is lower than that provided by the identification of carotid plaques. The role of IMT as surrogate endpoint to assess the efficacy of cardiovascular protective therapies is also still debated. In fact, no studies have ever been designed and powered to show a relationship between changes in carotid IMT during follow-up and cardiovascular events. Recently, two metaanalysis of trials using IMT as surrogate endpoint failed to demonstrate an association between IMT regression and cardiovascular events. The reasons for the lack of predictive role for changes in IMT are uncertain. It has been shown that IMT is not a pure atherosclerotic index, being substantially affected by age and hemodynamic factors including blood pressure and vessel wall shear stress. In addition, the status of carotid vessels does not strictly reflect that of coronary arteries. Finally, intra and inter-observer variability of measurements may further limit the association between IMT changes in individual patients and cardiovascular risk. Thus, IMT represents a valuable risk marker in population studies but its role for tailoring cardiovascular therapy in clinical practice remains currently uncertain. Carotid Intima Media Thickness Cardiovascular risk prediction cardiovascular prevention. Medicine R Francesca Musella verfasserin aut Susanna Mosca verfasserin aut Laura Casaretti verfasserin aut Roberto Formisano verfasserin aut Giacomo Mattiello verfasserin aut Ada Bologna verfasserin aut Irma Fabiani verfasserin aut Francesco Gambardella verfasserin aut Laura Petraglia verfasserin aut Giuseppe Rengo verfasserin aut Dario Leosco verfasserin aut Pasquale Perrone-Filardi verfasserin aut In Monaldi Archives for Chest Disease PAGEPress Publications, 2019 76(2015), 3 (DE-627)537441069 (DE-600)2375904-5 25325264 nnns volume:76 year:2015 number:3 https://doi.org/10.4081/monaldi.2011.184 kostenfrei https://doaj.org/article/a980aad72661462192e086498dd834ed kostenfrei https://www.monaldi-archives.org/index.php/macd/article/view/184 kostenfrei https://doaj.org/toc/1122-0643 Journal toc kostenfrei https://doaj.org/toc/2532-5264 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 76 2015 3 |
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10.4081/monaldi.2011.184 doi (DE-627)DOAJ006769705 (DE-599)DOAJa980aad72661462192e086498dd834ed DE-627 ger DE-627 rakwb eng Enrico Vassallo verfasserin aut Clinical and therapeutic value of carotid intima-media thickness 2015 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Carotid Intima Media Thickness (IMT) has been widely used to predict cardiovascular events in primary and secondary prevention studies. Yet, the power of IMT to reclassify risk level on top of conventional risk assessment based on classical risk factors remains unsettled. In fact, recent data indicate that the prognostic power of IMT is lower than that provided by the identification of carotid plaques. The role of IMT as surrogate endpoint to assess the efficacy of cardiovascular protective therapies is also still debated. In fact, no studies have ever been designed and powered to show a relationship between changes in carotid IMT during follow-up and cardiovascular events. Recently, two metaanalysis of trials using IMT as surrogate endpoint failed to demonstrate an association between IMT regression and cardiovascular events. The reasons for the lack of predictive role for changes in IMT are uncertain. It has been shown that IMT is not a pure atherosclerotic index, being substantially affected by age and hemodynamic factors including blood pressure and vessel wall shear stress. In addition, the status of carotid vessels does not strictly reflect that of coronary arteries. Finally, intra and inter-observer variability of measurements may further limit the association between IMT changes in individual patients and cardiovascular risk. Thus, IMT represents a valuable risk marker in population studies but its role for tailoring cardiovascular therapy in clinical practice remains currently uncertain. Carotid Intima Media Thickness Cardiovascular risk prediction cardiovascular prevention. Medicine R Francesca Musella verfasserin aut Susanna Mosca verfasserin aut Laura Casaretti verfasserin aut Roberto Formisano verfasserin aut Giacomo Mattiello verfasserin aut Ada Bologna verfasserin aut Irma Fabiani verfasserin aut Francesco Gambardella verfasserin aut Laura Petraglia verfasserin aut Giuseppe Rengo verfasserin aut Dario Leosco verfasserin aut Pasquale Perrone-Filardi verfasserin aut In Monaldi Archives for Chest Disease PAGEPress Publications, 2019 76(2015), 3 (DE-627)537441069 (DE-600)2375904-5 25325264 nnns volume:76 year:2015 number:3 https://doi.org/10.4081/monaldi.2011.184 kostenfrei https://doaj.org/article/a980aad72661462192e086498dd834ed kostenfrei https://www.monaldi-archives.org/index.php/macd/article/view/184 kostenfrei https://doaj.org/toc/1122-0643 Journal toc kostenfrei https://doaj.org/toc/2532-5264 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 76 2015 3 |
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10.4081/monaldi.2011.184 doi (DE-627)DOAJ006769705 (DE-599)DOAJa980aad72661462192e086498dd834ed DE-627 ger DE-627 rakwb eng Enrico Vassallo verfasserin aut Clinical and therapeutic value of carotid intima-media thickness 2015 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Carotid Intima Media Thickness (IMT) has been widely used to predict cardiovascular events in primary and secondary prevention studies. Yet, the power of IMT to reclassify risk level on top of conventional risk assessment based on classical risk factors remains unsettled. In fact, recent data indicate that the prognostic power of IMT is lower than that provided by the identification of carotid plaques. The role of IMT as surrogate endpoint to assess the efficacy of cardiovascular protective therapies is also still debated. In fact, no studies have ever been designed and powered to show a relationship between changes in carotid IMT during follow-up and cardiovascular events. Recently, two metaanalysis of trials using IMT as surrogate endpoint failed to demonstrate an association between IMT regression and cardiovascular events. The reasons for the lack of predictive role for changes in IMT are uncertain. It has been shown that IMT is not a pure atherosclerotic index, being substantially affected by age and hemodynamic factors including blood pressure and vessel wall shear stress. In addition, the status of carotid vessels does not strictly reflect that of coronary arteries. Finally, intra and inter-observer variability of measurements may further limit the association between IMT changes in individual patients and cardiovascular risk. Thus, IMT represents a valuable risk marker in population studies but its role for tailoring cardiovascular therapy in clinical practice remains currently uncertain. Carotid Intima Media Thickness Cardiovascular risk prediction cardiovascular prevention. Medicine R Francesca Musella verfasserin aut Susanna Mosca verfasserin aut Laura Casaretti verfasserin aut Roberto Formisano verfasserin aut Giacomo Mattiello verfasserin aut Ada Bologna verfasserin aut Irma Fabiani verfasserin aut Francesco Gambardella verfasserin aut Laura Petraglia verfasserin aut Giuseppe Rengo verfasserin aut Dario Leosco verfasserin aut Pasquale Perrone-Filardi verfasserin aut In Monaldi Archives for Chest Disease PAGEPress Publications, 2019 76(2015), 3 (DE-627)537441069 (DE-600)2375904-5 25325264 nnns volume:76 year:2015 number:3 https://doi.org/10.4081/monaldi.2011.184 kostenfrei https://doaj.org/article/a980aad72661462192e086498dd834ed kostenfrei https://www.monaldi-archives.org/index.php/macd/article/view/184 kostenfrei https://doaj.org/toc/1122-0643 Journal toc kostenfrei https://doaj.org/toc/2532-5264 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 76 2015 3 |
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10.4081/monaldi.2011.184 doi (DE-627)DOAJ006769705 (DE-599)DOAJa980aad72661462192e086498dd834ed DE-627 ger DE-627 rakwb eng Enrico Vassallo verfasserin aut Clinical and therapeutic value of carotid intima-media thickness 2015 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Carotid Intima Media Thickness (IMT) has been widely used to predict cardiovascular events in primary and secondary prevention studies. Yet, the power of IMT to reclassify risk level on top of conventional risk assessment based on classical risk factors remains unsettled. In fact, recent data indicate that the prognostic power of IMT is lower than that provided by the identification of carotid plaques. The role of IMT as surrogate endpoint to assess the efficacy of cardiovascular protective therapies is also still debated. In fact, no studies have ever been designed and powered to show a relationship between changes in carotid IMT during follow-up and cardiovascular events. Recently, two metaanalysis of trials using IMT as surrogate endpoint failed to demonstrate an association between IMT regression and cardiovascular events. The reasons for the lack of predictive role for changes in IMT are uncertain. It has been shown that IMT is not a pure atherosclerotic index, being substantially affected by age and hemodynamic factors including blood pressure and vessel wall shear stress. In addition, the status of carotid vessels does not strictly reflect that of coronary arteries. Finally, intra and inter-observer variability of measurements may further limit the association between IMT changes in individual patients and cardiovascular risk. Thus, IMT represents a valuable risk marker in population studies but its role for tailoring cardiovascular therapy in clinical practice remains currently uncertain. Carotid Intima Media Thickness Cardiovascular risk prediction cardiovascular prevention. Medicine R Francesca Musella verfasserin aut Susanna Mosca verfasserin aut Laura Casaretti verfasserin aut Roberto Formisano verfasserin aut Giacomo Mattiello verfasserin aut Ada Bologna verfasserin aut Irma Fabiani verfasserin aut Francesco Gambardella verfasserin aut Laura Petraglia verfasserin aut Giuseppe Rengo verfasserin aut Dario Leosco verfasserin aut Pasquale Perrone-Filardi verfasserin aut In Monaldi Archives for Chest Disease PAGEPress Publications, 2019 76(2015), 3 (DE-627)537441069 (DE-600)2375904-5 25325264 nnns volume:76 year:2015 number:3 https://doi.org/10.4081/monaldi.2011.184 kostenfrei https://doaj.org/article/a980aad72661462192e086498dd834ed kostenfrei https://www.monaldi-archives.org/index.php/macd/article/view/184 kostenfrei https://doaj.org/toc/1122-0643 Journal toc kostenfrei https://doaj.org/toc/2532-5264 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 76 2015 3 |
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Clinical and therapeutic value of carotid intima-media thickness |
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Carotid Intima Media Thickness (IMT) has been widely used to predict cardiovascular events in primary and secondary prevention studies. Yet, the power of IMT to reclassify risk level on top of conventional risk assessment based on classical risk factors remains unsettled. In fact, recent data indicate that the prognostic power of IMT is lower than that provided by the identification of carotid plaques. The role of IMT as surrogate endpoint to assess the efficacy of cardiovascular protective therapies is also still debated. In fact, no studies have ever been designed and powered to show a relationship between changes in carotid IMT during follow-up and cardiovascular events. Recently, two metaanalysis of trials using IMT as surrogate endpoint failed to demonstrate an association between IMT regression and cardiovascular events. The reasons for the lack of predictive role for changes in IMT are uncertain. It has been shown that IMT is not a pure atherosclerotic index, being substantially affected by age and hemodynamic factors including blood pressure and vessel wall shear stress. In addition, the status of carotid vessels does not strictly reflect that of coronary arteries. Finally, intra and inter-observer variability of measurements may further limit the association between IMT changes in individual patients and cardiovascular risk. Thus, IMT represents a valuable risk marker in population studies but its role for tailoring cardiovascular therapy in clinical practice remains currently uncertain. |
| abstractGer |
Carotid Intima Media Thickness (IMT) has been widely used to predict cardiovascular events in primary and secondary prevention studies. Yet, the power of IMT to reclassify risk level on top of conventional risk assessment based on classical risk factors remains unsettled. In fact, recent data indicate that the prognostic power of IMT is lower than that provided by the identification of carotid plaques. The role of IMT as surrogate endpoint to assess the efficacy of cardiovascular protective therapies is also still debated. In fact, no studies have ever been designed and powered to show a relationship between changes in carotid IMT during follow-up and cardiovascular events. Recently, two metaanalysis of trials using IMT as surrogate endpoint failed to demonstrate an association between IMT regression and cardiovascular events. The reasons for the lack of predictive role for changes in IMT are uncertain. It has been shown that IMT is not a pure atherosclerotic index, being substantially affected by age and hemodynamic factors including blood pressure and vessel wall shear stress. In addition, the status of carotid vessels does not strictly reflect that of coronary arteries. Finally, intra and inter-observer variability of measurements may further limit the association between IMT changes in individual patients and cardiovascular risk. Thus, IMT represents a valuable risk marker in population studies but its role for tailoring cardiovascular therapy in clinical practice remains currently uncertain. |
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Carotid Intima Media Thickness (IMT) has been widely used to predict cardiovascular events in primary and secondary prevention studies. Yet, the power of IMT to reclassify risk level on top of conventional risk assessment based on classical risk factors remains unsettled. In fact, recent data indicate that the prognostic power of IMT is lower than that provided by the identification of carotid plaques. The role of IMT as surrogate endpoint to assess the efficacy of cardiovascular protective therapies is also still debated. In fact, no studies have ever been designed and powered to show a relationship between changes in carotid IMT during follow-up and cardiovascular events. Recently, two metaanalysis of trials using IMT as surrogate endpoint failed to demonstrate an association between IMT regression and cardiovascular events. The reasons for the lack of predictive role for changes in IMT are uncertain. It has been shown that IMT is not a pure atherosclerotic index, being substantially affected by age and hemodynamic factors including blood pressure and vessel wall shear stress. In addition, the status of carotid vessels does not strictly reflect that of coronary arteries. Finally, intra and inter-observer variability of measurements may further limit the association between IMT changes in individual patients and cardiovascular risk. Thus, IMT represents a valuable risk marker in population studies but its role for tailoring cardiovascular therapy in clinical practice remains currently uncertain. |
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