Incidence of stroke is related to carotid IMT even in the absence of plaque

The carotid intima-media thickness (IMT) has been associated with incidence of stroke. Whether this association is independent of carotid plaque is controversial. Methods and results: The associations among B-mode ultrasound determined common carotid IMT, carotid plaque (focal IMT > 1.2 mm) and incident stroke, were investigated in 5163 Swedish middle-aged men and women over a median follow-up of 7 years. Age and sex-adjusted carotid IMT, and carotid plaque were significantly (p < 0.05) related to future stroke. Adjustment for cardiovascular risk factors generally reduced the hazard rate ratios, however more prominently so with regard to the carotid measure of plaque than with IMT. The associations between carotid IMT and stroke remained after adjustment for presence of carotid plaque, and graded associations between carotid IMT and stroke was found both among those with and without carotid plaque. Conclusions: In this population-based study, common carotid IMT was associated with incidence of stroke. This relation was independent of presence of carotid plaque.