Although atherosclerosis starts in early life, evidence on risk factors and atherosclerosis in individuals aged <45 years is scarce. Therefore, we studied the relationship between risk factors, common carotid intima-media thickness (CIMT), and first-time cardiovascular events in adults aged <45 years. Our study population consisted of 3067 adults aged <45 years free from symptomatic cardiovascular disease at baseline, derived from 6 cohorts that are part of the USE-IMT initiative, an individual participant data meta-analysis of general-population-based cohort studies evaluating CIMT measurements. Information on risk factors, CIMT measurements, and follow-up of the combined end point (first-time myocardial infarction or stroke) was obtained. We assessed the relationship between risk factors and CIMT and the relationship between CIMT and first-time myocardial infarction or stroke using a multivariable linear mixed-effects model and a Cox proportional-hazards model, respectively. During a follow-up of 16.3 years, 55 first-time myocardial infarctions or strokes occurred. Median CIMT was 0.63 mm. Of the risk factors under study, age, sex, diastolic blood pressure, body mass index, total cholesterol, and high-density lipoprotein cholesterol related to CIMT. Furthermore, CIMT related to first-time myocardial infarction or stroke with a hazard ratio of 1.40 per SD increase in CIMT, independent of risk factors (95% confidence interval, 1.11-1.76). CIMT may be a valuable marker for cardiovascular risk in adults aged <45 years who are not yet eligible for standard cardiovascular risk screening. This is especially relevant in those with an increased, unfavor-able risk factor burden.
AD - From the Department of Radiology (A.L.M.E.), Department of Cardiovascular Epidemiology, Julius Center for Health Sciences and Primary Care (K.A.G., D.E.G., S.A.E.P., M.L.B., H.M.d.R.), and Department of Experimental Cardiology (I.E.H., H.M.d.R.), University Medical Center, Utrecht, Utrecht, The Netherlands; Department of Cardiac Sciences and Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada (T.J.A.); Department of Epidemiology and Public Health University College London, London, United Kingdom (A.R.B.); Department of Clinical Sciences in Malmo, Lund University, Skane University Hospital, Malmo, Sweden (G.E., B.H., M.R.); Department of Biostatistical Sciences and Neurology, Wake Forest School of Medicine, Winston-Salem, NC (G.W.E.); Division of Vascular Medicine, Department of General Internal Medicine, Radboud University Medical Centre Nijmegen, Nijmegen, The Netherlands (J.d.G., S.H.); Department of Clinical Epidemiology, University of Malaya Medical Center, Kuala Lumpur, Malaysia (D.E.G.); Osaka Medical Center for Health Science and Promotion, Osaka, Japan (A.I., A.K.); Department of Neurology, Tokyo Women Medical University, Tokyo, Japan (K.K.); Division of Cardiology and Population Health Research Institute, Department of Medicine, McMaster University, Hamilton, Ontario, Canada (E.M.L.); Department of Neurology, University Hospital, Goethe-University, Frankfurt am Main, Germany (M.W.L., M.S.); Brain and Circulation Research Group, Department of Clinical Medicine, University of Tromso, Tromso, Norway (E.B.M.); Department of General Practice, EMGO Institute, VU Medical Center, Amsterdam, The Netherlands (G.N., J.M.D.); Stroke Center, Department of Neurology, Osaka University Graduate School of Medicine, Osaka, Japan (S.O.); Department of Radiology, Tufts Medical Center, Boston, MA (D.H.O'L., J.F.P.); Centre for Population Health Sciences, University of Edinburgh, Edinburgh, United Kingdom (J.F.P., C.R.); Cardiology Division, Department of Internal Medicine, University of Virginia, Charlottesville (C.M.R.); Department of Neurology, Miller School of Medicine, University of Miami, FL (T.R.); MAS-Metabolic Analytical Services Oy, Helsinki, Finland (J.T.S.); Department of Neurology, Klinikum Herford, Herford, Germany (M.S.); Department of Internal Medicine and Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands (C.D.A.S.); and Nuffield Department of Population Health, The George Institute for Global Health, University of Oxford, Oxford, United Kingdom (S.A.E.P.). a.l.m.eikendal@umcutrecht.nl.Although atherosclerosis starts in early life, evidence on risk factors and atherosclerosis in individuals aged <45 years is scarce. Therefore, we studied the relationship between risk factors, common carotid intima-media thickness (CIMT), and first-time cardiovascular events in adults aged <45 years. Our study population consisted of 3067 adults aged <45 years free from symptomatic cardiovascular disease at baseline, derived from 6 cohorts that are part of the USE-IMT initiative, an individual participant data meta-analysis of general-population-based cohort studies evaluating CIMT measurements. Information on risk factors, CIMT measurements, and follow-up of the combined end point (first-time myocardial infarction or stroke) was obtained. We assessed the relationship between risk factors and CIMT and the relationship between CIMT and first-time myocardial infarction or stroke using a multivariable linear mixed-effects model and a Cox proportional-hazards model, respectively. During a follow-up of 16.3 years, 55 first-time myocardial infarctions or strokes occurred. Median CIMT was 0.63 mm. Of the risk factors under study, age, sex, diastolic blood pressure, body mass index, total cholesterol, and high-density lipoprotein cholesterol related to CIMT. Furthermore, CIMT related to first-time myocardial infarction or stroke with a hazard ratio of 1.40 per SD increase in CIMT, independent of risk factors (95% confidence interval, 1.11-1.76). CIMT may be a valuable marker for cardiovascular risk in adults aged <45 years who are not yet eligible for standard cardiovascular risk screening. This is especially relevant in those with an increased, unfavor-able risk factor burden.
PY - 2015 SN - 1524-4563 (Electronic)