Author(s):
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Eikendal, A.L.; Groenewegen, K.A.; Anderson, T.J.; Britton, A.R.; Engstrom, G.; Evans, G.W.;
Graaf, J. de
; Grobbee, D.E.; Hedblad, B.; Holewijn, S.; Ikeda, A.; Kitagawa, K.; Kitamura, A.; Lonn, E.M.; Lorenz, M.W.; Mathiesen, E.B.; Nijpels, G.; Dekker, J.M.; Okazaki, S.; O'Leary, D.H.; Polak, J.F.; Price, J.F.; Robertson, C.; Rembold, C.M.; Rosvall, M.; Rundek, T.; Salonen, J.T.; Sitzer, M.; Stehouwer, C.D.; Hoefer, I.E.; Peters, S.A.; Bots, M.L.; Ruijter, H.M. Den
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Subject:
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Radboudumc 16: Vascular damage RIHS: Radboud Institute for Health Sciences |
Abstract:
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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, unfavorable risk factor burden.
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