Carotid Intima-Media Thickness in Cardiovascular Risk Assessment

Carotid intima-media thickness (CIMT) is the combined thickness of the innermost two layers of the carotid artery wall, measured non-invasively by high-resolution ultrasonography. As a surrogate marker of subclinical atherosclerosis, CIMT reflects early structural changes associated with lipid accumulation, inflammation and vascular remodelling. Its prognostic value lies in its capacity to predict future cardiovascular events—myocardial infarction, stroke and vascular death—independently of traditional risk factors such as age, blood pressure, lipids and smoking status. CIMT measurement is particularly useful in individuals at intermediate risk, where it may refine risk stratification and guide preventive interventions. Worldwide, standardisation of scanning protocols, automated edge-detection software and training of sonographers have improved reproducibility. Emerging approaches integrate plaque assessment, arterial stiffness and advanced analytics to enhance risk prediction. Practical applications include tailoring statin therapy, monitoring response to lifestyle or pharmacological interventions and informing shared decision-making in clinical practice. As research evolves, CIMT remains central to understanding early atherogenesis, evaluating novel therapies and implementing precision cardiovascular prevention on a global scale.

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Carotid Intima-Media Thickness in Cardiovascular Risk Assessment publication trend

The graph below shows the total number of articles in carotid intima-media thickness in cardiovascular risk assessment across all publications each year (not limited to Nature Index journals).

Technical terms

Carotid intima-media thickness (CIMT): Combined thickness of the intimal and medial arterial layers, measured by B-mode ultrasound as an indicator of early atherosclerosis.

Atherosclerotic plaque: Focal deposition of lipids, inflammatory cells and fibrous tissue within the arterial wall, detectable as protrusions into the lumen during ultrasound imaging.

Subclinical atherosclerosis: Early, asymptomatic stage of arterial disease characterised by structural changes without overt cardiovascular events.

Endotype: Subgroup defined by shared pathobiological mechanisms or clinical characteristics, used to personalise disease assessment and management.

References

1. A machine learning based approach to identify carotid subclinical atherosclerosis endotypes. Cardiovascular Research (2023).
2. Development and validation of explainable machine-learning models for carotid atherosclerosis early screening. Journal of Translational Medicine (2023).
3. Predictive value for cardiovascular events of common carotid intima media thickness and its rate of change in individuals at high cardiovascular risk – Results from the PROG-IMT collaboration. PLOS ONE (2018).