Title | Carotid Intima-Media Thickness and the Risk of Sudden Cardiac Death: The ARIC Study and the CHS. |
Publication Type | Journal Article |
Year of Publication | 2020 |
Authors | Suzuki, T, Wang, W, Wilsdon, A, Butler, KR, Adabag, S, Griswold, ME, Nambi, V, Rosamond, W, Sotoodehnia, N, Mosley, TH |
Journal | J Am Heart Assoc |
Volume | 9 |
Issue | 19 |
Pagination | e016981 |
Date Published | 2020 Oct 20 |
ISSN | 2047-9980 |
Abstract | <p>Background Sudden cardiac death (SCD) is associated with severe coronary heart disease in the great majority of cases. Whether carotid intima-media thickness (C-IMT), a known surrogate marker of subclinical atherosclerosis, is associated with risk of SCD in a general population remains unknown. The objective of this study was to investigate the association between C-IMT and risk of SCD. Methods and Results We examined a total of 20 862 participants: 15 307 participants of the ARIC (Atherosclerosis Risk in Communities) study and 5555 participants of the CHS (Cardiovascular Health Study). C-IMT and common carotid artery intima-media thickness was measured at baseline by ultrasound. Presence of plaque was judged by trained readers. Over a median of 23.5 years of follow-up, 569 participants had SCD (1.81 cases per 1000 person-years) in the ARIC study. Mean C-IMT and common carotid artery intima-media thickness were associated with risk of SCD after adjustment for traditional risk factors and time-varying adjustors: hazard ratios (HRs) with 95% CIs for fourth versus first quartile were 1.64 (1.15-2.63) and 1.49 (1.05-2.11), respectively. In CHS, 302 participants developed SCD (4.64 cases per 1000 person-years) over 13.1 years. Maximum C-IMT was associated with risk of SCD after adjustment: HR (95% CI) for fourth versus first quartile was 1.75 (1.22-2.51). Presence of plaque was associated with 35% increased risk of SCD: HR (95% CI) of 1.37 (1.13-1.67) in the ARIC study and 1.32 (1.04-1.68) in CHS. Conclusions C-IMT was associated with risk of SCD in 2 biracial community-based cohorts. C-IMT may be used as a marker of SCD risk and potentially to initiate early therapeutic interventions to mitigate the risk.</p> |
DOI | 10.1161/JAHA.120.016981 |
Alternate Journal | J Am Heart Assoc |
PubMed ID | 32975158 |