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dc.contributor.authorAmato M
dc.contributor.authorVeglia F
dc.contributor.authorde Faire U
dc.contributor.authorGiral P
dc.contributor.authorRauramaa R
dc.contributor.authorSmit AJ
dc.contributor.authorKurl S
dc.contributor.authorRavani A
dc.contributor.authorFrigerio B
dc.contributor.authorSansaro D
dc.contributor.authorBonomi A
dc.contributor.authorTedesco CC
dc.contributor.authorCastelnuovo S
dc.contributor.authorMannarino E
dc.contributor.authorHumphries SE
dc.contributor.authorHamsten A
dc.contributor.authorTremoli E
dc.contributor.authorBaldassarre D
dc.contributor.authoron behalf of the IMPROVE study group
dc.date.accessioned2017-12-13T13:51:19Z
dc.date.available2017-12-13T13:51:19Z
dc.date.issued2017
dc.identifier.urihttps://erepo.uef.fi/handle/123456789/5062
dc.description.abstractBackground and aims Carotid plaque size and the mean common carotid intima-media thickness measured in plaque-free areas (PF CC-IMTmean) have been identified as predictors of vascular events (VEs), but their complementarity in risk prediction and stratification is still unresolved. The aim of this study was to evaluate the independence of carotid plaque thickness and PF CC-IMTmean in cardiovascular risk prediction and risk stratification. Methods The IMPROVE-study is a European cohort (n = 3703), where the thickness of the largest plaque detected in the whole carotid tree was indexed as cIMTmax. PF CC-IMTmean was also assessed. Hazard Ratios (HR) comparing the top quartiles of cIMTmax and PF CC-IMTmean versus their respective 1–3 quartiles were calculated using Cox regression. Results After a 36.2-month follow-up, there were 215 VEs (125 coronary, 73 cerebral and 17 peripheral). Both cIMTmax and PF CC-IMTmean were mutually independent predictors of combined-VEs, after adjustment for center, age, sex, risk factors and pharmacological treatment [HR (95% CI) = 1.98 (1.47, 2.67) and 1.68 (1.23, 2.29), respectively]. Both variables were independent predictors of cerebrovascular events (ischemic stroke, transient ischemic attack), while only cIMTmax was an independent predictor of coronary events (myocardial infarction, sudden cardiac death, angina pectoris, angioplasty, coronary bypass grafting). In reclassification analyses, PF CC-IMTmean significantly adds to a model including both Framingham Risk Factors and cIMTmax (Integrated Discrimination Improvement; IDI = 0.009; p = 0.0001) and vice-versa (IDI = 0.02; p < 0.0001). Conclusions cIMTmax and PF CC-IMTmean are independent predictors of VEs, and as such, they should be used as additive rather than alternative variables in models for cardiovascular risk prediction and reclassification.en
dc.language.isoENen
dc.publisherElsevier BVen
dc.relation.ispartofseriesATHEROSCLEROSISen
dc.relation.urihttp://dx.doi.org/10.1016/j.atherosclerosis.2017.05.023en
dc.rightsCC BY-NC-ND https://creativecommons.org/licenses/by-nc-nd/4.0/en
dc.titleCarotid plaque-thickness and common carotid IMT show additive value in cardiovascular risk prediction and reclassificationen
dc.description.versionpublished versionen
dc.contributor.departmentSchool of Medicine / Biomedicineen
dc.contributor.departmentSchool of Medicine / Clinical Medicineen
uef.solecris.id48034346en
dc.type.publicationinfo:eu-repo/semantics/articleen
dc.rights.accessrights© Authorsen
dc.relation.projectidinfo:eu-repo/grantAgreement/EC/FP5-LIFE QUALITY/QLG1-CT-2002-00896/EU/Carotid intima media thickness (imt) and imt-progression as predictors of vascular events in a high risk population (improve)/IMPROVEen
dc.relation.doi10.1016/j.atherosclerosis.2017.05.023en
dc.description.reviewstatuspeerRevieweden
dc.format.pagerange412-419en
dc.relation.issn0021-9150en
dc.relation.volume263en
dc.rights.accesslevelopenAccessen
dc.type.okmA1en
dc.type.versioninfo:eu-repo/semantics/publishedVersionen
uef.solecris.openaccessHybridijulkaisukanavassa ilmestynyt avoin julkaisu


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