Although current cardiovascular risk equations perform reasonably well in predicting disease, improvement is still needed.\u00a0 One way to do this would be to include a measure of preclinical atherosclerosis in risk prediction algorithms.\u00a0 Measurement of common carotid initima-media thickness (CIMT) could be of use in this regard, but evidence that it can aid existing risk scores in prediction of the absolute risk of cardiovascular events has been inconsistent.<\/p>\n
In this meta-analysis, the authors\u2019 aim was to determine whether common CIMT could improve the 10-year risk prediction of first-time myocardial infarction and stroke above that of the Framingham risk score.\u00a0 Relevant studies performed between 1950 and 2012 were selected, where patients had had a baseline CIMT performed and were then followed up for a first cardiovascular event.\u00a0 Individual data were combined into one data set and an individual participant data meta-analysis was performed on individuals without existing cardiovascular disease.<\/p>\n
14 population-based cohorts were analysed, contributing data for 45,828 individuals.\u00a0 Over a median follow-up of 11 years, 4007 first-time myocardial infarctions or strokes occurred.\u00a0 The authors looked at the accuracy of the Framingham risk score with and without the incorporation of CIMT.\u00a0 The C statistic of both models was similar, and the net reclassification improvement with the addition of common CIMT was small (0.8%). Looking specifically at those at intermediate risk, the net reclassification improvement was 3.6% in all individuals, with no differences noted between men and women.<\/p>\n