Traditional risk factors are not major contributors to the variance in carotid intima-media thickness

Tatjana Rundek, Susan H Blanton, Susanne Bartels, Chuanhui Dong, Ami Raval, Ryan T. Demmer, Digna Cabral, Mitchell S V Elkind, Ralph L Sacco, Moise Desvarieux

Research output: Contribution to journalArticle

55 Citations (Scopus)

Abstract

BACKGROUND AND PURPOSE-: Carotid intima-media thickness (cIMT) was a widely accepted ultrasound marker of subclinical atherosclerosis in the past. Although traditional risk factors may explain ≈50% of the variance in plaque burden, they may not explain such a high proportion of the variance in IMT, especially when measured in plaque-freel ocations. We aimed this study to identify individuals with cIMT unexplained by traditional risk factors for future environmental and genetic research. METHODS-: As part of the Northern Manhattan Study, 1790 stroke-free individuals (mean age, 69±9 years; 60% women; 61% Hispanic; 19% black; 18% white) were assessed for cIMT using B-mode carotid ultrasound. Multiple linear regression models were evaluated: (1) incorporating prespecified traditional risk factors; and (2) including less traditional factors, such as inflammation biomarkers, adiponectin, homocysteine, and kidney function. Standardized cIMT residual scores were constructed to select individuals with unexplained cIMT. RESULTS-: Mean total cIMT was 0.92±0.09 mm. The traditional model explained 11% of the variance in cIMT. Age (7%), male sex (3%), glucose (<1%), pack-years of smoking (<1%), and low-density lipoprotein cholesterol (<1%) were significant contributing factors. The model, including inflammatory biomarkers, explained 16% of the variance in cIMT. Adiponectin was the only additional significant contributor to the variance in cIMT. We identified 358 individuals (20%) with cIMT unexplained by the investigated risk factors. CONCLUSIONS-: Vascular risk factors explain only a small proportion of variance in cIMT. Identification of novel genetic and environmental factors underlying unexplained subclinical atherosclerosis is of utmost importance for future effective prevention of vascular disease.

Original languageEnglish
Pages (from-to)2101-2108
Number of pages8
JournalStroke
Volume44
Issue number8
DOIs
StatePublished - Aug 1 2013

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Carotid Intima-Media Thickness
Adiponectin
Linear Models
Atherosclerosis
Biomarkers
Genetic Research
Homocysteine
Vascular Diseases
Hispanic Americans
LDL Cholesterol
Smoking
Stroke

Keywords

  • carotid intima-media thickness
  • carotid ultrasound
  • risk factors

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Clinical Neurology
  • Advanced and Specialized Nursing

Cite this

Traditional risk factors are not major contributors to the variance in carotid intima-media thickness. / Rundek, Tatjana; Blanton, Susan H; Bartels, Susanne; Dong, Chuanhui; Raval, Ami; Demmer, Ryan T.; Cabral, Digna; Elkind, Mitchell S V; Sacco, Ralph L; Desvarieux, Moise.

In: Stroke, Vol. 44, No. 8, 01.08.2013, p. 2101-2108.

Research output: Contribution to journalArticle

Rundek, Tatjana ; Blanton, Susan H ; Bartels, Susanne ; Dong, Chuanhui ; Raval, Ami ; Demmer, Ryan T. ; Cabral, Digna ; Elkind, Mitchell S V ; Sacco, Ralph L ; Desvarieux, Moise. / Traditional risk factors are not major contributors to the variance in carotid intima-media thickness. In: Stroke. 2013 ; Vol. 44, No. 8. pp. 2101-2108.
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abstract = "BACKGROUND AND PURPOSE-: Carotid intima-media thickness (cIMT) was a widely accepted ultrasound marker of subclinical atherosclerosis in the past. Although traditional risk factors may explain ≈50{\%} of the variance in plaque burden, they may not explain such a high proportion of the variance in IMT, especially when measured in plaque-freel ocations. We aimed this study to identify individuals with cIMT unexplained by traditional risk factors for future environmental and genetic research. METHODS-: As part of the Northern Manhattan Study, 1790 stroke-free individuals (mean age, 69±9 years; 60{\%} women; 61{\%} Hispanic; 19{\%} black; 18{\%} white) were assessed for cIMT using B-mode carotid ultrasound. Multiple linear regression models were evaluated: (1) incorporating prespecified traditional risk factors; and (2) including less traditional factors, such as inflammation biomarkers, adiponectin, homocysteine, and kidney function. Standardized cIMT residual scores were constructed to select individuals with unexplained cIMT. RESULTS-: Mean total cIMT was 0.92±0.09 mm. The traditional model explained 11{\%} of the variance in cIMT. Age (7{\%}), male sex (3{\%}), glucose (<1{\%}), pack-years of smoking (<1{\%}), and low-density lipoprotein cholesterol (<1{\%}) were significant contributing factors. The model, including inflammatory biomarkers, explained 16{\%} of the variance in cIMT. Adiponectin was the only additional significant contributor to the variance in cIMT. We identified 358 individuals (20{\%}) with cIMT unexplained by the investigated risk factors. CONCLUSIONS-: Vascular risk factors explain only a small proportion of variance in cIMT. Identification of novel genetic and environmental factors underlying unexplained subclinical atherosclerosis is of utmost importance for future effective prevention of vascular disease.",
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AU - Blanton, Susan H

AU - Bartels, Susanne

AU - Dong, Chuanhui

AU - Raval, Ami

AU - Demmer, Ryan T.

AU - Cabral, Digna

AU - Elkind, Mitchell S V

AU - Sacco, Ralph L

AU - Desvarieux, Moise

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N2 - BACKGROUND AND PURPOSE-: Carotid intima-media thickness (cIMT) was a widely accepted ultrasound marker of subclinical atherosclerosis in the past. Although traditional risk factors may explain ≈50% of the variance in plaque burden, they may not explain such a high proportion of the variance in IMT, especially when measured in plaque-freel ocations. We aimed this study to identify individuals with cIMT unexplained by traditional risk factors for future environmental and genetic research. METHODS-: As part of the Northern Manhattan Study, 1790 stroke-free individuals (mean age, 69±9 years; 60% women; 61% Hispanic; 19% black; 18% white) were assessed for cIMT using B-mode carotid ultrasound. Multiple linear regression models were evaluated: (1) incorporating prespecified traditional risk factors; and (2) including less traditional factors, such as inflammation biomarkers, adiponectin, homocysteine, and kidney function. Standardized cIMT residual scores were constructed to select individuals with unexplained cIMT. RESULTS-: Mean total cIMT was 0.92±0.09 mm. The traditional model explained 11% of the variance in cIMT. Age (7%), male sex (3%), glucose (<1%), pack-years of smoking (<1%), and low-density lipoprotein cholesterol (<1%) were significant contributing factors. The model, including inflammatory biomarkers, explained 16% of the variance in cIMT. Adiponectin was the only additional significant contributor to the variance in cIMT. We identified 358 individuals (20%) with cIMT unexplained by the investigated risk factors. CONCLUSIONS-: Vascular risk factors explain only a small proportion of variance in cIMT. Identification of novel genetic and environmental factors underlying unexplained subclinical atherosclerosis is of utmost importance for future effective prevention of vascular disease.

AB - BACKGROUND AND PURPOSE-: Carotid intima-media thickness (cIMT) was a widely accepted ultrasound marker of subclinical atherosclerosis in the past. Although traditional risk factors may explain ≈50% of the variance in plaque burden, they may not explain such a high proportion of the variance in IMT, especially when measured in plaque-freel ocations. We aimed this study to identify individuals with cIMT unexplained by traditional risk factors for future environmental and genetic research. METHODS-: As part of the Northern Manhattan Study, 1790 stroke-free individuals (mean age, 69±9 years; 60% women; 61% Hispanic; 19% black; 18% white) were assessed for cIMT using B-mode carotid ultrasound. Multiple linear regression models were evaluated: (1) incorporating prespecified traditional risk factors; and (2) including less traditional factors, such as inflammation biomarkers, adiponectin, homocysteine, and kidney function. Standardized cIMT residual scores were constructed to select individuals with unexplained cIMT. RESULTS-: Mean total cIMT was 0.92±0.09 mm. The traditional model explained 11% of the variance in cIMT. Age (7%), male sex (3%), glucose (<1%), pack-years of smoking (<1%), and low-density lipoprotein cholesterol (<1%) were significant contributing factors. The model, including inflammatory biomarkers, explained 16% of the variance in cIMT. Adiponectin was the only additional significant contributor to the variance in cIMT. We identified 358 individuals (20%) with cIMT unexplained by the investigated risk factors. CONCLUSIONS-: Vascular risk factors explain only a small proportion of variance in cIMT. Identification of novel genetic and environmental factors underlying unexplained subclinical atherosclerosis is of utmost importance for future effective prevention of vascular disease.

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