Villines TC, et al. – This study was carried out to assess the utility of carotid intima-media thickness (CIMT) values for the prediction of incident coronary heart disease and stroke events in blacks. In a community–based African American (AA) cohort, an association was apparent between CIMT and incident cardiovascular diseases (CVD) but CIMT offered modest incremental improvement in risk reclassification beyond traditional risk factors.

Methods

• At the baseline examination (2000–2004) of the Jackson Heart Study (JHS), AA adults 21-94 years of age (mean 54) underwent bilateral far-wall CIMT measurement (mean 0.76 mm).
• Researchers assessed incident CVD events over 7-11 years of follow-up (2000-2011) from samples of 2,463 women (107 CVD events) and 1,338 men (64 CVD events) who were free of clinical CVD at baseline.

Results

• Findings demonstrated that each 0.2 mm increase in CIMT was associated with age-adjusted incident CVD hazard ratios of 1.4 (95% confidence interval: 1.2, 1.5) for women and 1.3 (1.1, 1.6) for men.
• Researchers observed that classification accuracy improved only slightly when comparing multivariable models that used traditional risk factors alone versus models that added CIMT: C-statistics 0.837 (0.794, 0.881) versus 0.842 (0.798, 0.886) in women and 0.754 (0.683, 0.826) versus 0.763 (0.701, 0.825) in men.
• Similarly, data highlighted that risk-reclassification was only mildly improved by adding CIMT: Net Reclassification Index (NRI) 0.13 (p = 0.05) and 0.05 (p = 0.50) for women and men, respectively; Integrated Discrimination Improvement (IDI) 0.02 (p = 0.02) and 0.01 (p = 0.26) for women and men, respectively.