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Updated: Jun 8, 2026

A Methodological Approach to Non-invasive Assessments of Vascular Function and Morphology
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Enhancing Cardiovascular Risk Prediction with a Simplified Carotid IMT Protocol: Evidence from the IMPROVE Study.

Fabrizio Veglia1, Anna Maria Malagoni1, Mauro Amato2

  • 1Maria Cecilia Hospital, GVM Care & Research, 48033 Cotignola, Italy.

Biomedicines
|March 28, 2025
PubMed
Summary
This summary is machine-generated.

A new carotid intima-media thickness (CIMT) measurement, 1CC-IMTmean-of-2-max, significantly improves cardiovascular risk prediction. This simplified method enhances the accuracy of risk scores like SCORE2/SCORE2-OP for primary prevention screening.

Keywords:
IMPROVE studycarotid arteryintima-media thicknessplaqueultrasonography protocol

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Area of Science:

  • Cardiology
  • Vascular Biology
  • Preventive Medicine

Background:

  • Carotid intima-media thickness (CIMT) is a traditional marker for subclinical atherosclerosis.
  • Previous CIMT methods faced challenges in standardization and reproducibility, questioning their clinical utility.
  • Standardized CIMT protocols are needed for reliable cardiovascular risk assessment.

Purpose of the Study:

  • To evaluate the predictive ability of two novel CIMT variables using a simplified protocol.
  • To determine if these new CIMT variables improve cardiovascular risk stratification beyond existing risk scores.
  • To assess the potential of a standardized CIMT measurement for widespread clinical application.

Main Methods:

  • A multicentre, longitudinal, observational study involving 3165 participants from the IMPROVE study.
  • Measured two new CIMT variables: 1CC-IMTmean-of-2-max and BIF-IMTmean-of-2-max.
  • Assessed predictive performance by quantifying the increase in ROC AUC over the SCORE2/SCORE2-OP risk algorithm.

Main Results:

  • During a median 7.1-year follow-up, 367 major vascular events occurred.
  • Both tested CIMT variables showed association with cardiovascular risk.
  • 1CC-IMTmean-of-2-max significantly enhanced the predictive accuracy of SCORE2/SCORE2-OP (ROC AUC increase +0.017, p=0.014).

Conclusions:

  • The 1CC-IMTmean-of-2-max measurement significantly improves cardiovascular risk prediction.
  • This simplified and standardized CIMT protocol shows promise for mass screening.
  • It offers a valuable tool for enhancing risk assessment in primary cardiovascular prevention.