Publications [#366328] of James A. Blumenthal

Journal Articles

1. Willeit, P; Tschiderer, L; Allara, E; Reuber, K; Seekircher, L; Gao, L; Liao, X; Lonn, E; Gerstein, HC; Yusuf, S; Brouwers, FP; Asselbergs, FW; van Gilst, W; Anderssen, SA; Grobbee, DE; Kastelein, JJP; Visseren, FLJ; Ntaios, G; Hatzitolios, AI; Savopoulos, C; Nieuwkerk, PT; Stroes, E; Walters, M; Higgins, P; Dawson, J; Gresele, P; Guglielmini, G; Migliacci, R; Ezhov, M; Safarova, M; Balakhonova, T; Sato, E; Amaha, M; Nakamura, T; Kapellas, K; Jamieson, LM; Skilton, M; Blumenthal, JA; Hinderliter, A; Sherwood, A; Smith, PJ; van Agtmael, MA; Reiss, P; van Vonderen, MGA; Kiechl, S; Klingenschmid, G; Sitzer, M; Stehouwer, CDA; Uthoff, H; Zou, Z-Y; Cunha, AR; Neves, MF; Witham, MD; Park, H-W; Lee, M-S; Bae, J-H; Bernal, E; Wachtell, K; Kjeldsen, SE; Olsen, MH; Preiss, D; Sattar, N; Beishuizen, E; Huisman, MV; Espeland, MA; Schmidt, C; Agewall, S; Ok, E; Aşçi, G; de Groot, E; Grooteman, MPC; Blankestijn, PJ; Bots, ML; Sweeting, MJ; Thompson, SG; Lorenz, MW; PROG-IMT and the Proof-ATHERO Study Groups, (2020). Carotid Intima-Media Thickness Progression as Surrogate Marker for Cardiovascular Risk: Meta-Analysis of 119 Clinical Trials Involving 100 667 Patients.. Circulation, 142(7), 621-642. [doi]
   (last updated on 2024/01/01)

   Abstract:
   BACKGROUND: To quantify the association between effects of interventions on carotid intima-media thickness (cIMT) progression and their effects on cardiovascular disease (CVD) risk. METHODS: We systematically collated data from randomized, controlled trials. cIMT was assessed as the mean value at the common-carotid-artery; if unavailable, the maximum value at the common-carotid-artery or other cIMT measures were used. The primary outcome was a combined CVD end point defined as myocardial infarction, stroke, revascularization procedures, or fatal CVD. We estimated intervention effects on cIMT progression and incident CVD for each trial, before relating the 2 using a Bayesian meta-regression approach. RESULTS: We analyzed data of 119 randomized, controlled trials involving 100 667 patients (mean age 62 years, 42% female). Over an average follow-up of 3.7 years, 12 038 patients developed the combined CVD end point. Across all interventions, each 10 μm/y reduction of cIMT progression resulted in a relative risk for CVD of 0.91 (95% Credible Interval, 0.87-0.94), with an additional relative risk for CVD of 0.92 (0.87-0.97) being achieved independent of cIMT progression. Taken together, we estimated that interventions reducing cIMT progression by 10, 20, 30, or 40 μm/y would yield relative risks of 0.84 (0.75-0.93), 0.76 (0.67-0.85), 0.69 (0.59-0.79), or 0.63 (0.52-0.74), respectively. Results were similar when grouping trials by type of intervention, time of conduct, time to ultrasound follow-up, availability of individual-participant data, primary versus secondary prevention trials, type of cIMT measurement, and proportion of female patients. CONCLUSIONS: The extent of intervention effects on cIMT progression predicted the degree of CVD risk reduction. This provides a missing link supporting the usefulness of cIMT progression as a surrogate marker for CVD risk in clinical trials.