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Updated: Jun 6, 2026

A Methodological Approach to Non-invasive Assessments of Vascular Function and Morphology
09:33

A Methodological Approach to Non-invasive Assessments of Vascular Function and Morphology

Published on: February 7, 2015

Does carotid intima-media thickness regression predict reduction of cardiovascular events? A meta-analysis of 41

Pierluigi Costanzo1, Pasquale Perrone-Filardi, Enrico Vassallo

  • 1Department of Internal Medicine,cardiovascular Sciences, and Immunology, Federico II University, Naples, Italy. pcostanz@alice.it

Journal of the American College of Cardiology
|December 4, 2010
PubMed

Insights

Reducing intima-media thickness (IMT) through cardiovascular drug therapies does not significantly lower the incidence of cardiovascular events like coronary heart disease or cerebrovascular events. Favorable changes in IMT do not necessarily translate to reduced clinical outcomes.

Area of Science:

  • Cardiovascular Medicine
  • Medical Imaging
  • Evidence-Based Medicine

Background:

  • Increased carotid intima-media thickness (IMT) is linked to higher risks of coronary heart disease (CHD) and cerebrovascular (CBV) events.
  • The prognostic significance of favorable changes in IMT remains uncertain.

Purpose of the Study:

  • To determine if intima-media thickness (IMT) regression is associated with a reduced incidence of cardiovascular events.
  • To investigate the relationship between IMT changes and clinical outcomes in patients receiving cardiovascular therapies.

Main Methods:

  • A meta-regression analysis of 41 randomized trials involving 18,307 participants was conducted.
  • Searched MEDLINE and Cochrane databases for trials reporting carotid IMT and clinical endpoints.
  • Explored the influence of baseline characteristics, risk profiles, and trial quality on the IMT-outcome association.

Main Results:

  • Active treatments significantly reduced CHD, CBV events, and all-cause death.
  • No significant relationship was found between IMT regression and reduced CHD events, CBV events, or all-cause death.
  • Baseline characteristics, cardiovascular risk, IMT levels, and trial quality did not influence the IMT-outcome association.

Conclusions:

  • Regression or slowed progression of carotid IMT induced by cardiovascular drug therapies does not reflect a reduction in cardiovascular events.
  • Favorable changes in IMT do not serve as a reliable surrogate marker for reduced cardiovascular event incidence.
Abstract

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