Carotid intima-media thickness in plaque-free site, carotid plaques and coronary heart disease risk prediction in older adults. The Three-City Study
Section snippets
Population
The Three-City Study is a French multisite prospective study investigating the determinants of coronary heart disease, stroke and dementia. Details of the protocol have been described previously. [21] Briefly, 9294 community dwellers 65 years or older were selected between March 1999 and March 2001 from the electoral rolls of 3 French cities (Bordeaux, South-West, n = 2104; Dijon, North-East, n = 4931; Montpellier, South, n = 2259). The study protocol was approved by the Ethical Committee of the
Baseline characteristics
The mean (SD) age was 73.3 (4.9) years and 37.1% were men. The mean (SD) CCA-IMT was 0.712 (0.120) mm and 44.4% had at least carotid plaques at one site. The mean levels of the risk factors were higher and the use of medications more frequent in those with carotid plaques and in those with higher CCA-IMT (Table 1A, Table 1B). The mean CCA-IMT increased with the number of sites with carotid plaques and vice versa.
Associations with incident CHD
After a median follow-up of 5.4 years, 223 subjects had a first ever CHD event.
Discussion
In this large prospective cohort of older adults, the risk of CHD over 6 years increased with ultrasound-detected carotid plaques but not with mean CCA-IMT measured at a site free of any discrete plaques. Furthermore, presence or absence of ultrasound-detected carotid plaques improved significantly CHD risk prediction beyond conventional risk factors.
Authors contributions
Conception and design, acquisition of data: Christophe Tzourio, Karen Ritchie and Pierre Ducimetière.
Analysis and interpretation of data, drafting of the manuscript: Matthieu Plichart.
Critical revision of the manuscript for important intellectual content: David S Celermajer, Mahmoud Zureik, Catherine Helmer, Xavier Jouven, Karen Ritchie, Christophe Tzourio, Pierre Ducimetière and Jean-Philippe Empana.
Drafting of the manuscript, supervision, had full access to all the data and takes
Conflict of interest disclosures
None
Acknowledgments
The Three-City Study is conducted under a partnership agreement between the Institut National de la Santé et de la Recherche Médicale (INSERM), the Victor Segalen – Bordeaux II University, and Sanofi-Aventis. The Fondation pour la Recherche Médicale funded the preparation and initiation of the study. The 3C Study is also supported by the Caisse Nationale Maladie des Travailleurs Salariés, Direction Générale de la Santé, MGEN, Institut de la Longévité, Conseils Régionaux of Aquitaine and
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