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Observational Study
. 2016 Nov-Dec;68(6):821-827.
doi: 10.1016/j.ihj.2016.04.009. Epub 2016 Apr 28.

A Study to derive distribution of carotid intima media thickness and to determine its COrrelation with cardiovascular Risk factors in asymptomatic nationwidE Indian population (SCORE-India)

Ravi R Kasliwal  1 , Manish Bansal  2 , Nagaraj Desai  3 , Bhavesh Kotak  4 , Ammar Raza  4 , Hardik Vasnawala  4 , Amit Kumar  4 ; SCORE-India collaborators
Collaborators, Affiliations
Observational Study

A Study to derive distribution of carotid intima media thickness and to determine its COrrelation with cardiovascular Risk factors in asymptomatic nationwidE Indian population (SCORE-India)

Ravi R Kasliwal et al. Indian Heart J. 2016 Nov-Dec.

Abstract

Background: There is presently no data to describe normal distribution of carotid intima-media thickness (CIMT), an established measure of subclinical atherosclerosis, in Indian subjects.

Methods: In this multi-centric study, 1229 subjects with age ≥30 years and no previous cardiovascular disease (CVD) underwent CVD risk factor assessment and CIMT measurement. Mean far wall common carotid artery IMT was measured on both sides and averaged.

Results: Mean age of the subjects was 48.0±12.0 years and 54.2% were men. CIMT measurement was feasible in 1157 subjects. Mean, median and 75th percentile values of CIMT for different age-groups were derived for men and women separately. There was a progressive increase in CIMT with increasing age (P<0.001) and men had higher CIMT values than women (0.608±0.12mm vs. 0.579±0.11mm, P<0.001). The CIMT values were also higher in diabetics (0.635±0.10mm) and hypertensives (0.624±0.10mm) as compared to non-diabetics (0.589±0.12mm, P<0.001) and non-hypertensives (0.592±0.12, P 0.02) respectively. Among continuous variables, age, systolic blood pressure and fasting blood glucose had strong to modest correlation with CIMT (Pearson's r 0.524, 0.282 and 0.192 respectively, all P values <0.001), whereas body mass index, diastolic blood pressure and serum triglycerides exhibited weak but still statistically significant relationship (Pearson's r 0.069, P 0.019; Pearson's r 0.065, P 0.026; and Pearson's r 0.094, P 0.001, respectively).

Conclusions: This is the first study to provide age- and gender-specific distribution of CIMT in Indian subjects free from CVD. This information should help facilitate further research and clinical work involving CIMT in India.

Keywords: Primary prevention; Risk stratification; Secondary prevention; Subclinical atherosclerosis.

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Figures

Fig. 1
Fig. 1
Longitudinal image of carotid bifurcation showing distal part of common carotid artery, carotid bifurcation and the proximal segments of external and internal carotid arteries. ‘Double lines’ of intima and adventitia are also seen at the far wall of the common carotid artery. CCA, common carotid artery; ECA, external carotid artery; ICA, internal carotid artery
Fig. 2
Fig. 2
Carotid intima media thickness measurement using the off-line analysis software.
Fig. 3
Fig. 3
Age- and gender-wise distribution of mean carotid intima-media thickness in the study population. All values represent median values.
Fig. 4
Fig. 4
Bland–Altman limits of agreement for intra-observer reproducibility of carotid intima media thickness measurement in the present study.
See this image and copyright information in PMC

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