Abstract 10630: Predictors of Changes in Carotid Artery Intima-Media Thickness and Plaque Score Over a Decade of Aging: The Multi-Ethnic Study of Atherosclerosis (MESA)
Background: Carotid artery intima-media thickness (CIMT) and plaque (CP) are non-invasive ultrasonographic markers of subclinical arterial injury that predict incident cardiovascular disease (CVD); We evaluated predictors of changes in CIMT, CP score, and development of new CP in MESA, a longitudinal multiethnic cohort.
Methods: CIMT and CP were evaluated in MESA participants at exam 1 and exam 5, a mean (standard deviation) of 9.4 (0.5) years later. All participants were free of prevalent CVD at baseline. Far wall CIMT was measured in both common carotid arteries. The CP score was obtained from images of the internal, bulb, and common carotid segments of both carotid arteries (range 0-12). Multivariable linear, zero-inflated Poisson, and logistic regression models were used to evaluate associations of CVD risk factors at exam 1 with mean-mean CIMT progression (μm/year), CP score progression, and formation of new CP.
Results: At baseline, the 3409 MESA participants were 60.1 (9.4) years old (53% female; 26% African-American, 22% Hispanic, 13% Chinese) and 1588 (47%) had CP. Statins were used more frequently in those with CP (p<0.0001). Mean CIMT progression was 12.1 (12.9) μm/year. The CP score increased from 1.1 (1.6) to 2.3 (2.4); 729 (21%) developed new CP. Changes in CIMT were less in Chinese (β=-2.846, p=0.001) and Hispanic participants (β=-1.803, p=0.018), and inversely associated with baseline high-density lipoprotein cholesterol (HDL-C, β=-0.044, p=0.02) and antihypertensive use (β=-2.049, p=0.0004). An increase in CP score was inversely associated with being Chinese (β=-0.574, p=0.01) or African-American (β=-0.353, p=0.046) and baseline HDL-C (β=-0.011, p=0.034). Increasing age (β=0.060, p<0.0001), systolic blood pressure (β=0.010, p=0.016), and current tobacco use (β=0.638, p=0.003) were associated with CP score progression. Baseline statin was strongly and inversely predictive of new CP development (β=-0.364, p=0.008).
Discussion In a large, multi-ethnic cohort with almost a decade of follow up, Chinese ancestry and HDL-C protected from increasing CIMT and CP score. Traditional CVD risk factors predicted CP score progression. Statin use was a marker of CP presence, but was strongly and inversely predictive of developing new CP.
- © 2013 by American Heart Association, Inc.