Preliminary Results Indicate Carotid Intima-Media Thickness Is Biomarker of Atherosclerosis

Title: Preliminary Results Indicate Carotid Intima-Media Thickness Is Biomarker of Atherosclerosis: Presented at DALM


"Preliminary Results Indicate Carotid Intima-Media Thickness Is Biomarker of Atherosclerosis: Presented at DALM"By Crina Frincu-Mallos, PhD NEW YORK, NY -- October 12, 2007 -- Overall data from the IMPROVE trial support the concept that carotid intima-media thickness (IMT) and IMT progression constitute novel biomarkers of atherosclerotic disease, according to a study presented here on at the XVI International Symposium on Drugs Affecting Lipid Metabolism (DALM).


Elena Tremoli, MD, Professor and Director, Department of Pharmacological Sciences, University of Milan, and Research Coordinator, Centro Cardiologico Monzino, IRCCS, Milan, Italy, presented the data on October 6.


The Carotid IMT and IMT-PROgression as Predictors of Vascular Events in a High Risk European Population (IMPROVE) study is an ongoing prospective, multicentre, longitudinal study with 3,711 patients from six European countries. All patients were classified as being at high risk for cardiovascular disease with at least three vascular risk factors, said Dr. Tremoli.


Patient enrollment ended in April 2005; patients were recruited from Finland (n=1,050), Sweden (n=533), The Netherlands (n=532), France (n=501), and Italy (n=1,095).


This patient population consists of men and women in approximately a 1:1 ratio (aged 64 +- 5 years). The largest percentage of patients have familial hypercholesterolaemia (78.6%); 23.9% of patients have diabetes.


The study is designed to determine whether it is feasible to predict new vascular events based on the progression of carotid IMT, "alone or after integration with conventional and nonconventional risk factors," explained Dr. Tremoli. IMT, a novel surrogate marker of atherosclerosis, is measured by high-resolution B-mode ultrasound.


Preliminary results indicate a significant connection between high sensitivity C-reactive protein (hs-CRP) and gender in the overall population. "Hs-CRP is a determinant of carotid IMT in men only," said Dr. Tremoli. However, cigarette smoking unmasks the association between hs-CRP and carotid IMT in women, she added.

The study monitored the occurrence of cardiovascular events over a period of 36 months.

A total of 135 first events occurred in the 3,393 patients enrolled in the trial, the most common event being angina pectoris (n=45), angioplasty/stent (n=39), stroke (n=21), and coronary bypass (n=16).


In addition, the researchers observed a geographic (North-South) gradient in carotid IMT when they analysed the baseline data.


The preliminary data support the concept that carotid IMT is a biomarker of atherosclerotic disease, concluded Dr. Tremoli. Data on the predictive capacity of carotid IMT-progression should be available by the end of next year.


Funding for this study was provided by the Italian Ministry of Health, European Commission, and the IMPROVE project.


Presentation title: Carotid Intima Media Thickness as Marker of Atherosclerosis: Results of the IMPROVE Study. Abstract 159.