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BACKGROUND Carotid intima-media thickness and carotid plaque are well-established imaging markers used to capture different stages of the atherosclerotic disease process. We aimed to quantify to which extent carotid intima-media thickness predicts incidence of first-ever carotid plaque. MATERIALS AND METHODS Two independent reviewers conducted a comprehensive literature search of PubMed and Web of Science. To be eligible for inclusion, prospective studies were required to involve participants free of carotid plaque at baseline and repor