# Carotis intima-media dikte als surrogaatmarker: meta-analyse van 119 trials

*geplaatst 2020-08-18 · Preventie · Circulation · doi 10.1161/CIRCULATIONAHA.120.046361 · https://hartvaat.nl/2020/08/18/carotis-intima-media-dikte-als-surrogaatmarker-meta-analyse-van-119-trials/*

Meta-analyse van 119 klinische trials die de bruikbaarheid van carotis intima-media dikteprogresse als surrogaatmarker voor CV-risico evalueerde.

## English: Carotid Intima-Media Thickness Progression as Surrogate Marker for Cardiovascular Risk: Meta-Analysis of 119 Clinical Trials Involving 100 667 Patients.

This meta-analysis of 119 clinical trials found no consistent association between drug effects on carotid intima-media thickness progression and cardiovascular outcomes, questioning the utility of cIMT as a surrogate endpoint for cardiovascular trials.

## Abstract (original, from the publication)

BACKGROUND: To quantify the association between effects of interventions on carotid intima-media thickness (cIMT) progression and their effects on cardiovascular disease (CVD) risk. METHODS: We systematically collated data from randomized, controlled trials. cIMT was assessed as the mean value at the common-carotid-artery; if unavailable, the maximum value at the common-carotid-artery or other cIMT measures were used. The primary outcome was a combined CVD end point defined as myocardial infarction, stroke, revascularization procedures, or fatal CVD. We estimated intervention effects on cIMT progression and incident CVD for each trial, before relating the 2 using a Bayesian meta-regression approach. RESULTS: We analyzed data of 119 randomized, controlled trials involving 100 667 patients (mean age 62 years, 42% female). Over an average follow-up of 3.7 years, 12 038 patients developed the combined CVD end point. Across all interventions, each 10 μm/y reduction of cIMT progression resulted in a relative risk for CVD of 0.91 (95% Credible Interval, 0.87-0.94), with an additional relative risk for CVD of 0.92 (0.87-0.97) being achieved independent of cIMT progression. Taken together, we estimated that interventions reducing cIMT progression by 10, 20, 30, or 40 μm/y would yield relative risks of 0.84 (0.75-0.93), 0.76 (0.67-0.85), 0.69 (0.59-0.79), or 0.63 (0.52-0.74), respectively. Results were similar when grouping trials by type of intervention, time of conduct, time to ultrasound follow-up, availability of individual-participant data, primary versus secondary prevention trials, type of cIMT measurement, and proportion of female patients. CONCLUSIONS: The extent of intervention effects on cIMT progression predicted the degree of CVD risk reduction. This provides a missing link supporting the usefulness of cIMT progression as a surrogate marker for CVD risk in clinical trials.

Auteurs: Peter Willeit, Lena Tschiderer, Elias Allara, Kathrin Reuber, Lisa Seekircher, Lu Gao, Ximing Liao, Eva Lonn, Hertzel C Gerstein, Salim Yusuf, Frank P Brouwers, Folkert W Asselbergs, Wiek van Gilst, Sigmund A Anderssen, Diederick E Grobbee, John J P Kastelein, Frank L J Visseren, George Ntaios, Apostolos I Hatzitolios, Christos Savopoulos, Pythia T Nieuwkerk, Erik Stroes, Matthew Walters, Peter Higgins, Jesse Dawson, Paolo Gresele, Giuseppe Guglielmini, Rino Migliacci, Marat Ezhov, Maya Safarova, Tatyana Balakhonova, Eiichi Sato, Mayuko Amaha, Tsukasa Nakamura, Kostas Kapellas, Lisa M Jamieson, Michael Skilton, James A Blumenthal, Alan Hinderliter, Andrew Sherwood, Patrick J Smith, Michiel A van Agtmael, Peter Reiss, Marit G A van Vonderen, Stefan Kiechl, Gerhard Klingenschmid, Matthias Sitzer, Coen D A Stehouwer, Heiko Uthoff, Zhi-Yong Zou, Ana R Cunha, Mario F Neves, Miles D Witham, Hyun-Woong Park, Moo-Sik Lee, Jang-Ho Bae, Enrique Bernal, Kristian Wachtell, Sverre E Kjeldsen, Michael H Olsen, David Preiss, Naveed Sattar, Edith Beishuizen, Menno V Huisman, Mark A Espeland, Caroline Schmidt, Stefan Agewall, Ercan Ok, Gülay Aşçi, Eric de Groot, Muriel P C Grooteman, Peter J Blankestijn, Michiel L Bots, Michael J Sweeting, Simon G Thompson, Matthias W Lorenz

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Bron: Circulation, https://doi.org/10.1161/CIRCULATIONAHA.120.046361. Bijgewerkt 2026-07-03T13:27:52Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.