Carotid intima-media thickness (cIMT) and plaque from risk assessment and clinical use to genetic discoveries

SummaryCarotid intima–media thickness (cIMT) and carotid plaque are ultrasound imaging measures of carotid atherosclerosis and strong predictors of future stroke, myocardial infarction and vascular death. The use of ultrasound measures of cIMT and carotid plaque as a screening tool in clinical practice however have been extremely limited by a lack of recognition of its value by medical communities, health care policy makers and a lack of reimbursement by third-party payers engaged in the delivery of vascular imaging services. This review addresses the role of cIMT and plaque in vascular disease risk prediction. Recent data from large population based studies on reclassification of the vascular risk using carotid ultrasound imaging markers is presented. In addition, the common clinical scenarios for the appropriate use of cIMT in clinical setting are summarized according to the recent study conducted by the Society of the Atherosclerosis Imaging and Prevention in collaboration with the International Atherosclerosis Society. This presentation is intended to provide a practical guide for use of cIMT and plaque to clinicians to promote optimal clinical use of cIMT and to researchers to direct cIMT and plaque research towards investigating environmental and genetic factors of a complex disorder – subclinical atherosclerosis – leading to future genetic discoveries and new anti-atherosclerotic therapies.