Intima-media thickness (IMT) is increasingly used in clinical trials as a surrogate end point for determining the success of interventions that lower risk factors for atherosclerosis. The necessity for unified criteria to distinguish early atherosclerotic plaque formation from thickening of IMT and to standardize IMT measurements is addressed in this consensus statement. Plaque is defined as a focal structure that encroaches into the arterial lumen of at least 0.5 mm or 50% of the surrounding IMT value or demonstrates a thickness of ≧1.5 mm as measured from the media-adventitia interface to the intima-lumen interface. Standard use of IMT measurements is recommended in all epidemiological and interventional trials dealing with vascular diseases to improve characterization of the population investigated. The consensus concludes that there is no need to ‘treat IMT values’ nor to monitor IMT values in individual patients apart from few exceptions. Although IMT has been suggested to represent an important risk marker, it does not fulfill the characteristics of an accepted risk factor. Standardized methods recommended in this consensus statement will foster homogenous data collection and analysis. This will help to improve the power of studies incorporating IMT measurements and to facilitate the merging of large databases for meta-analyses.

Keywords:
Intima-media thickness, Ultrasound, Consensus, Stroke, Carotid artery, Review
1.
Ebrahim S, Papacosta O, Whincup P, Wannamethee G, Walker M, Nicolaides AN, Dhanjil S, Griffin M, Belcaro G, Rumley A, Lowe GD: Carotid plaque, intima media thickness, cardiovascular risk factors, and prevalent cardiovascular disease in men and women: The British Regional Heart Study. Stroke 1999;30:841–850.
2.
Glagov S, Weisenberg E, Zarins CK, Stankunavicius R, Kolettis GJ: Compensatory enlargement of human atherosclerotic coronary arteries. N Engl J Med 1987;1316:1371–1375.
3.
Magyar MT, Szikszai Z, Balla J, Valikovics A, Kappelmayer J, Imre S, Balla G, Jeney V, Csiba L, Bereczki D: Early-onset carotid atherosclerosis is associated with increased intima-media thickness and elevated serum levels of inflammatory markers. Stroke 2003;34:58–63.
4.
van der Meer IM, Iglesias del Sol A, Hak AE, Bots ML, Hofman A, Witteman JCM: Risk factors for progression of atherosclerosis measured at multiple sites in the arterial tree: The Rotterdam Study. Stroke 2003;34:2374–2379.
5.
Pignoli P, Tremoli E, Poli A, Oreste P, Paoletti R: Intimal plus medial thickness of the arterial wall: A direct measurement with ultrasound imaging. Circulation 1986;74:1399–1406.
6.
Rundek T, Elkind MS, Pittman J, et al: Carotid intima-media thickness is associated with allelic variants of stromelysin-1, interleukin-6, and hepatic lipase genes: The Northern Manhattan Prospective Cohort Study. Stroke 2002;33:1420–1423.
7.
Steinke W, Els T, Hennerici M: Compensatory carotid artery dilatation in early atherosclerosis. Circulation 1994;89:2578–2581.
8.
Taylor AJ, Burke AP, O’Malley PG, Farb A, Malcom GT, Smialek J, Virmani R: A comparison of the Framingham risk index, coronary artery calcification, and culprit plaque morphology in sudden cardiac death. Circulation 2000;101:1243–1248.
9.
Touboul PJ, Elbaz A, Koller C, Lucas C, Adrai V, Chedru F, Amarenco P: Common carotid artery intima-media thickness and brain infarction: The Etude du Profil Génétique de l’Infarctus Cérébral (GENIC) case-control study. The GENIC Investigators. Circulation 2000;102:313–318.
10.
Touboul PJ, Hennerici M: Epaisseur intima media AVC et traitements médicamenteux ‘IMT, Drugs and Stroke’. Paris, Datebe, 2002, p 108.
11.
Touboul PJ, Prati P, Scarabin PY, Adrai V, Thibout E, Ducimetiere P: Use of monitoring software to improve the measurement of carotid wall thickness by B-mode imaging. J Hypertens Suppl 1992;10:S37–S41.
12.
Woo KS, Chook P, Raitakari OT, McQuillan B, Feng, Celermajer DS: Westernization of Chinese adults and increased subclinical atherosclerosis. Arterioscler Thromb Vasc Biol 1999;19:2487–2493.
© 2004 S. Karger AG, Basel
2004
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