Carotid Intima-Media Thickness Progression and Risk of Vascular Events in People With Diabetes: Results From the PROG-IMT Collaboration

Matthias W. Lorenz; Jackie F. Price; Christine Robertson; Michiel L. Bots; Joseph F. Polak; Holger Poppert; Maryam Kavousi; Marcus Doerr; Eva Stensland; Pierre Ducimetiere; Kimmo Ronkainen; Stefan Kiechl; Matthias Sitzer; Tatjana Rundek; Lars Lind; Jing Liu; Goran Bergstrom; Liliana Grigore; Lena Bokemark; Alfonsa Friera; David Yanez; Horst Bickel; M. Arfan Ikram; Henry Voelzke; Stein Harald Johnsen; Jean Philippe Empana; Tomi-Pekka Tuomainen; Peter Willeit; Helmuth Steinmetz; Moise Desvarieux; Wuxiang Xie; Caroline Schmidt; Giuseppe D. Norata; Carmen Suarez; Dirk Sander; Albert Hofman; Ulf Schminke; Ellisiv Mathiesen; Matthieu Plichart; Jussi Kauhanen; Johann Willeit; Ralph L. Sacco; Stela McLachlan; Dong Zhao; Bjorn Fagerberg; Alberico L. Catapano; Rafael Gabriel; Oscar H. Franco; Alpaslan Buelbuel; Frank Scheckenbach; Anja Pflug; Lu Gao; Simon G. Thompson

doi:10.2337/dc14-2732

Carotid Intima-Media Thickness Progression and Risk of Vascular Events in People With Diabetes: Results From the PROG-IMT Collaboration

Matthias W. Lorenz^*, Jackie F. Price, Christine Robertson, Michiel L. Bots, Joseph F. Polak, Holger Poppert, Maryam Kavousi, Marcus Doerr, Eva Stensland, Pierre Ducimetiere, Kimmo Ronkainen, Stefan Kiechl, Matthias Sitzer, Tatjana Rundek, Lars Lind, Jing Liu, Goran Bergstrom, Liliana Grigore, Lena Bokemark, Alfonsa FrieraDavid Yanez, Horst Bickel, M. Arfan Ikram, Henry Voelzke, Stein Harald Johnsen, Jean Philippe Empana, Tomi-Pekka Tuomainen, Peter Willeit, Helmuth Steinmetz, Moise Desvarieux, Wuxiang Xie, Caroline Schmidt, Giuseppe D. Norata, Carmen Suarez, Dirk Sander, Albert Hofman, Ulf Schminke, Ellisiv Mathiesen, Matthieu Plichart, Jussi Kauhanen, Johann Willeit, Ralph L. Sacco, Stela McLachlan, Dong Zhao, Bjorn Fagerberg, Alberico L. Catapano, Rafael Gabriel, Oscar H. Franco, Alpaslan Buelbuel, Frank Scheckenbach, Anja Pflug, Lu Gao, Simon G. Thompson

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

Abstract / Description of output

OBJECTIVECarotid 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 METHODSIn 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.RESULTSAverage 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).CONCLUSIONSDespite 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.

Original language	English
Pages (from-to)	1921-1929
Number of pages	9
Journal	Diabetes Care
Volume	38
Issue number	10
Early online date	24 Sept 2015
DOIs	https://doi.org/10.2337/dc14-2732
Publication status	Published - Oct 2015

Keywords / Materials (for Non-textual outputs)

IMPAIRED GLUCOSE-TOLERANCE
CORONARY-HEART-DISEASE
NONFATAL MYOCARDIAL-INFARCTION
ARTERY INTIMA
CARDIOVASCULAR EVENTS
SUBCLINICAL ATHEROSCLEROSIS
META-REGRESSION
METAANALYSIS
COHORT
INDIVIDUALS

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10.2337/dc14-2732

Jackie Price
- Deanery of Molecular, Genetic and Population Health Sciences - Personal Chair of Molecular Epidemiology
- Usher Institute
- Centre for Global Health Research
Person: Academic: Research Active

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Lorenz, M. W., Price, J. F., Robertson, C., Bots, M. L., Polak, J. F., Poppert, H., Kavousi, M., Doerr, M., Stensland, E., Ducimetiere, P., Ronkainen, K., Kiechl, S., Sitzer, M., Rundek, T., Lind, L., Liu, J., Bergstrom, G., Grigore, L., Bokemark, L., ... Thompson, S. G. (2015). Carotid Intima-Media Thickness Progression and Risk of Vascular Events in People With Diabetes: Results From the PROG-IMT Collaboration. Diabetes Care, 38(10), 1921-1929. https://doi.org/10.2337/dc14-2732

@article{8969718d7f7540e4b01ee2f0ed52fa52,

title = "Carotid Intima-Media Thickness Progression and Risk of Vascular Events in People With Diabetes: Results From the PROG-IMT Collaboration",

abstract = "OBJECTIVECarotid 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 METHODSIn 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.RESULTSAverage 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).CONCLUSIONSDespite 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.",

keywords = "IMPAIRED GLUCOSE-TOLERANCE, CORONARY-HEART-DISEASE, NONFATAL MYOCARDIAL-INFARCTION, ARTERY INTIMA, CARDIOVASCULAR EVENTS, SUBCLINICAL ATHEROSCLEROSIS, META-REGRESSION, METAANALYSIS, COHORT, INDIVIDUALS",

author = "Lorenz, {Matthias W.} and Price, {Jackie F.} and Christine Robertson and Bots, {Michiel L.} and Polak, {Joseph F.} and Holger Poppert and Maryam Kavousi and Marcus Doerr and Eva Stensland and Pierre Ducimetiere and Kimmo Ronkainen and Stefan Kiechl and Matthias Sitzer and Tatjana Rundek and Lars Lind and Jing Liu and Goran Bergstrom and Liliana Grigore and Lena Bokemark and Alfonsa Friera and David Yanez and Horst Bickel and Ikram, {M. Arfan} and Henry Voelzke and Johnsen, {Stein Harald} and Empana, {Jean Philippe} and Tomi-Pekka Tuomainen and Peter Willeit and Helmuth Steinmetz and Moise Desvarieux and Wuxiang Xie and Caroline Schmidt and Norata, {Giuseppe D.} and Carmen Suarez and Dirk Sander and Albert Hofman and Ulf Schminke and Ellisiv Mathiesen and Matthieu Plichart and Jussi Kauhanen and Johann Willeit and Sacco, {Ralph L.} and Stela McLachlan and Dong Zhao and Bjorn Fagerberg and Catapano, {Alberico L.} and Rafael Gabriel and Franco, {Oscar H.} and Alpaslan Buelbuel and Frank Scheckenbach and Anja Pflug and Lu Gao and Thompson, {Simon G.}",

year = "2015",

month = oct,

doi = "10.2337/dc14-2732",

language = "English",

volume = "38",

pages = "1921--1929",

journal = "Diabetes Care",

issn = "0149-5992",

publisher = "American Diabetes Association Inc.",

number = "10",

}

Lorenz, MW, Price, JF, Robertson, C, Bots, ML, Polak, JF, Poppert, H, Kavousi, M, Doerr, M, Stensland, E, Ducimetiere, P, Ronkainen, K, Kiechl, S, Sitzer, M, Rundek, T, Lind, L, Liu, J, Bergstrom, G, Grigore, L, Bokemark, L, Friera, A, Yanez, D, Bickel, H, Ikram, MA, Voelzke, H, Johnsen, SH, Empana, JP, Tuomainen, T-P, 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, Buelbuel, A, Scheckenbach, F, Pflug, A, Gao, L & Thompson, SG 2015, 'Carotid Intima-Media Thickness Progression and Risk of Vascular Events in People With Diabetes: Results From the PROG-IMT Collaboration', Diabetes Care, vol. 38, no. 10, pp. 1921-1929. https://doi.org/10.2337/dc14-2732

TY - JOUR

T1 - Carotid Intima-Media Thickness Progression and Risk of Vascular Events in People With Diabetes

T2 - Results From the PROG-IMT Collaboration

AU - Lorenz, Matthias W.

AU - Price, Jackie F.

AU - Robertson, Christine

AU - Bots, Michiel L.

AU - Polak, Joseph F.

AU - Poppert, Holger

AU - Kavousi, Maryam

AU - Doerr, Marcus

AU - Stensland, Eva

AU - Ducimetiere, Pierre

AU - Ronkainen, Kimmo

AU - Kiechl, Stefan

AU - Sitzer, Matthias

AU - Rundek, Tatjana

AU - Lind, Lars

AU - Liu, Jing

AU - Bergstrom, Goran

AU - Grigore, Liliana

AU - Bokemark, Lena

AU - Friera, Alfonsa

AU - Yanez, David

AU - Bickel, Horst

AU - Ikram, M. Arfan

AU - Voelzke, Henry

AU - Johnsen, Stein Harald

AU - Empana, Jean Philippe

AU - Tuomainen, Tomi-Pekka

AU - Willeit, Peter

AU - Steinmetz, Helmuth

AU - Desvarieux, Moise

AU - Xie, Wuxiang

AU - Schmidt, Caroline

AU - Norata, Giuseppe D.

AU - Suarez, Carmen

AU - Sander, Dirk

AU - Hofman, Albert

AU - Schminke, Ulf

AU - Mathiesen, Ellisiv

AU - Plichart, Matthieu

AU - Kauhanen, Jussi

AU - Willeit, Johann

AU - Sacco, Ralph L.

AU - McLachlan, Stela

AU - Zhao, Dong

AU - Fagerberg, Bjorn

AU - Catapano, Alberico L.

AU - Gabriel, Rafael

AU - Franco, Oscar H.

AU - Buelbuel, Alpaslan

AU - Scheckenbach, Frank

AU - Pflug, Anja

AU - Gao, Lu

AU - Thompson, Simon G.

PY - 2015/10

Y1 - 2015/10

N2 - OBJECTIVECarotid 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 METHODSIn 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.RESULTSAverage 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).CONCLUSIONSDespite 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.

AB - OBJECTIVECarotid 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 METHODSIn 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.RESULTSAverage 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).CONCLUSIONSDespite 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.

KW - IMPAIRED GLUCOSE-TOLERANCE

KW - CORONARY-HEART-DISEASE

KW - NONFATAL MYOCARDIAL-INFARCTION

KW - ARTERY INTIMA

KW - CARDIOVASCULAR EVENTS

KW - SUBCLINICAL ATHEROSCLEROSIS

KW - META-REGRESSION

KW - METAANALYSIS

KW - COHORT

KW - INDIVIDUALS

U2 - 10.2337/dc14-2732

DO - 10.2337/dc14-2732

M3 - Article

SN - 0149-5992

VL - 38

SP - 1921

EP - 1929

JO - Diabetes Care

JF - Diabetes Care

IS - 10

ER -

Carotid Intima-Media Thickness Progression and Risk of Vascular Events in People With Diabetes: Results From the PROG-IMT Collaboration

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Jackie Price

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