Carotid intima-media thickness progression and risk of vascular events in people with diabetes: results from the PROG-IMT collaboration.

Pubmed ID: 26180107

Pubmed Central ID: PMC4580609

Journal: Diabetes care

Publication Date: Oct. 1, 2015

Affiliation: Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, U.K.

MeSH Terms: Humans, Male, Adult, Female, Aged, Aged, 80 and over, Risk Factors, Middle Aged, Proportional Hazards Models, Disease Progression, Diabetic Angiopathies, Diabetes Mellitus, Type 2, Carotid Artery, Common, Atherosclerosis, Carotid Intima-Media Thickness, Cooperative Behavior

Grants: N01-HC-85086, N01HC55222, N01HC85079, N01HC85086, R01 DE013094, R37 NS029993, U01 HL080295, N01-HC-15103, N01-HC-55222, RG/08/014/24067, R01-DE-13094, R37-NS-029993, U01-HL-080295, MR/L003120/1

Authors: Franco OH, Lorenz MW, Polak JF, Kavousi M, Völzke H, Tuomainen TP, Sander D, Plichart M, Catapano AL, Kiechl S, Rundek T, Desvarieux M, Lind L, Gao L, Bots ML, Thompson SG, Yanez D, Sacco RL, Hofman A, Johnsen SH, Stensland E, Sitzer M, Steinmetz H, Dörr M, Schminke U, Poppert H, Bickel H, Kauhanen J, Ronkainen K, Empana JP, Ducimetiere P, Norata GD, Grigore L, Willeit J, Bokemark L, Fagerberg B, Liu J, Zhao D, Ikram MA, Price JF, Robertson C, Willeit P, Bergström G, Bülbül A, Xie W, McLachlan S, Schmidt C, Friera A, Suarez C, Mathiesen E, Gabriel R, Scheckenbach F, Pflug A

Cite As: Lorenz MW, Price JF, Robertson C, Bots ML, Polak JF, Poppert H, Kavousi M, Dörr M, Stensland E, Ducimetiere P, Ronkainen K, Kiechl S, Sitzer M, Rundek T, Lind L, Liu J, Bergström G, Grigore L, Bokemark L, Friera A, Yanez D, Bickel H, Ikram MA, Völzke H, Johnsen SH, Empana JP, Tuomainen TP, Willeit P, Steinmetz H, Desvarieux M, Xie W, Schmidt C, Norata GD, Suarez C, Sander D, Hofman A, Schminke U, Mathiesen E, Plichart M, Kauhanen J, Willeit J, Sacco RL, McLachlan S, Zhao D, Fagerberg B, Catapano AL, Gabriel R, Franco OH, Bülbül A, Scheckenbach F, Pflug A, Gao L, Thompson SG. Carotid intima-media thickness progression and risk of vascular events in people with diabetes: results from the PROG-IMT collaboration. Diabetes Care 2015 Oct;38(10):1921-9. Epub 2015 Jul 15.

Studies:

Abstract

OBJECTIVE: Carotid intima-media thickness (CIMT) is a marker of subclinical organ damage and predicts cardiovascular disease (CVD) events in the general population. It has also been associated with vascular risk in people with diabetes. However, the association of CIMT change in repeated examinations with subsequent CVD events is uncertain, and its use as a surrogate end point in clinical trials is controversial. We aimed at determining the relation of CIMT change to CVD events in people with diabetes. RESEARCH DESIGN AND METHODS: In a comprehensive meta-analysis of individual participant data, we collated data from 3,902 adults (age 33-92 years) with type 2 diabetes from 21 population-based cohorts. We calculated the hazard ratio (HR) per standard deviation (SD) difference in mean common carotid artery intima-media thickness (CCA-IMT) or in CCA-IMT progression, both calculated from two examinations on average 3.6 years apart, for each cohort, and combined the estimates with random-effects meta-analysis. RESULTS: Average mean CCA-IMT ranged from 0.72 to 0.97 mm across cohorts in people with diabetes. The HR of CVD events was 1.22 (95% CI 1.12-1.33) per SD difference in mean CCA-IMT, after adjustment for age, sex, and cardiometabolic risk factors. Average mean CCA-IMT progression in people with diabetes ranged between -0.09 and 0.04 mm/year. The HR per SD difference in mean CCA-IMT progression was 0.99 (0.91-1.08). CONCLUSIONS: Despite reproducing the association between CIMT level and vascular risk in subjects with diabetes, we did not find an association between CIMT change and vascular risk. These results do not support the use of CIMT progression as a surrogate end point in clinical trials in people with diabetes.