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Carotid intima–media thickness: ultrasound measurement, prognostic value and role in clinical practice
  1. Satheesh Balakrishnan Nair1,2,
  2. Rayaz Malik1,2,
  3. Rajdeep S Khattar3
  1. 1Manchester Heart Centre, Manchester Royal Infirmary, Manchester, UK
  2. 2The University of Manchester, Manchester, UK
  3. 3Department of Cardiology, Royal Brompton and Harefield NHS Trust, London, UK
  1. Correspondence to Dr Rajdeep Singh Khattar, Consultant Cardiologist and Honorary Clinical Senior Lecturer, Royal Brompton and Harefield NHS Trust, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK; rskhattar{at}


Ultrasound measurement of carotid intima–media thickness (IMT) has become a valuable tool for detecting and monitoring progression of atherosclerosis and recently published recommendations provide guidance for proper standardisation of these measurements. Important determinants of carotid IMT include age, gender, systolic blood pressure, diabetes mellitus and serum cholesterol levels. Many studies have shown carotid IMT to correlate with the severity of coronary atherosclerosis assessed by CT coronary calcification scores, coronary angiography and intravascular ultrasound. Consistent with its correlation with cardiovascular risk factors and coronary artery disease, a meta-analysis of large observational studies has shown carotid IMT to be a strong predictor of future cardiovascular events. Moreover, in patients with established coronary artery disease a reduction in carotid IMT has been shown to translate into a reduction in future cardiovascular events. Consensus statements now also recommend carotid IMT measurements to further refine the prognostic assessment of patients traditionally considered to be at an intermediate risk of cardiovascular disease.

  • Cardiology
  • ischaemic heart disease
  • valvular heart disease
  • cardiac epidemiology
  • echocardiography
  • thoracic medicine
  • statistics and research methods
  • education and training (see medical education and training)
  • medical education and training
  • internal medicine

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  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.