|
Eagerness to use carotid intima-media thickness (CIMT) to assess cardiovascular risk is matched only by uncertainty about its value, judging from recent articles on the topic.
• Among the latest reports: French researchers prospectively assessed CIMT and other risk factors in a population of mostly middle-aged persons, and compared the results with subsequent cardiovascular events. CIMT measurements add little to standard risk factors in assessing the risk of either stroke or coronary heart disease, they concluded. Varying methods of analyzing CIMT made different studies "hardly comparable." [1]
• A systematic review from the Netherlands concluded that the evidence to support use of CIMT in cardiovascular screening is "limited." Another review, from authors at the University of Montreal, recommends CIMT only for refining the status of patients at intermediate risk of for heart disease. Because of inter-scan variability and the likelihood of small changes over time, they say, sequential CIMT measurements are not recommended. [2,3]
• For 36- to 59-year-old people who appear to be at low risk, CIMT is better than the coronary artery calcium score at detecting subclinical atherosclerosis, a team from Mayo Clinic Arizona reported last year, based on a small observational study. Because large, expensive studies are required to resolve the issue, they say, "clinicians must use a judgment-based approach to individual patient care." [4]
REFERENCES
http://www.searchmedica.com/search.html?q=CIMT%20cardiovascular%20risk&c=mu&ss=defLink&fr=true. Accessed 04/01/2010
[1] The value of carotid intima-media thickness for predicting cardiovascular risk
Arteriosclerosis, Thrombosis, and Vascular Biology (Pub Med) | Feb 1, 2010
[2] Carotid intima-media thickness measurement in cardiovascular screening programmes
European Journal of Cardiovascular Prevention and Rehabilitation (Pub Med) | Dec 1, 2009
[3]Screening for subclinical coronary artery disease measuring carotid intima media thickness American Journal of Cardiology (Pub Med) | Nov 1, 2009
[4] Carotid Intima-Media Thickness and Coronary Artery Calcium Score as Indications of Subclinical Atherosclerosis Mayo Clinic Proceedings | Feb 17, 2009
Ken Korber is a PA in Chicago and the architect of the first PA postgraduate fellowship curriculum for cardiovascular care in the United States. He can be reached at his email address, kenneth.korber@gmail.com, for any comments or questions.
The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.
RECOMMEND THIS ARTICLE
You must be logged in
to recommend articles
| 
