Predictors of anterior and posterior wall carotid intima media thickness progression in men and women at moderate risk of coronary heart disease

J Clin Lipidol. 2011 May-Jun;5(3):141-151. doi: 10.1016/j.jacl.2011.02.003. Epub 2011 Feb 12.


Background: The rate of carotid intima media thickness (CIMT) progression has been widely used in clinical trials as a surrogate marker for subclinical atherosclerosis.

Objective: The aim of this study was to investigate relationships between coronary heart disease (CHD) risk markers and progression of CIMT in patients at moderate CHD risk.

Methods: Participants included men (45-75 years) and women (55-74 years) in the control arm of a clinical trial. All had at least one major CHD risk factor and baseline posterior wall CIMT 0.7-2.0 mm, without significant stenosis. Posterior (n = 134) and anterior wall (in a subset, n = 72) CIMT were assessed with B-mode ultrasound at baseline and 12 and ∼18 months. Fasting lipoprotein lipid, apolipoprotein (Apo), inflammatory, and oxidative stress markers were evaluated.

Results: Baseline CIMT was inversely associated (P < .001) with CIMT progression. After adjustment for baseline CIMT, significant predictors of anterior wall CIMT progression in linear regression analyses included glucose (P = .044), high-density lipoprotein cholesterol (HDL-C, inverse, P = .006), triglycerides (TG, P = .006), and ratios of total cholesterol (TC)/HDL-C (P = .013), TG/HDL-C (P = .005), and Apo B/HDL-C (P = .021). Posterior wall CIMT progressed on average, whereas anterior wall CIMT regressed (0.0078 vs -0.0164 mm/year, P = .014). Significant baseline CIMT-adjusted predictors of posterior wall CIMT progression included TC (P = .028), low-density lipoprotein-C (P = .035), non-HDL-C (P = .004), TG (P = .016), Apo B (P = .005), and ratios of TC/HDL-C (P < .001), TG/HDL-C (P = .015), Apo B/Apo AI (P = .012) and Apo B/HDL-C (P = .004).

Conclusion: The strongest predictors for CIMT progression in anterior and posterior walls were lower baseline CIMT, increased TG, and elevated ratios, including TC/HDL-C, TG/HDL-C and Apo B/HDL-C.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Body Mass Index
  • Carotid Arteries / diagnostic imaging
  • Carotid Arteries / pathology*
  • Cholesterol, HDL / analysis
  • Coronary Disease / pathology*
  • Coronary Disease / prevention & control
  • Double-Blind Method
  • Female
  • Humans
  • Male
  • Middle Aged
  • Phytotherapy / methods
  • Predictive Value of Tests
  • Randomized Controlled Trials as Topic
  • Risk Factors
  • Triglycerides / analysis
  • Tunica Intima / diagnostic imaging
  • Tunica Intima / pathology*
  • Tunica Media / diagnostic imaging
  • Tunica Media / pathology*
  • Ultrasonography


  • Cholesterol, HDL
  • Triglycerides