Comparison of coronary artery calcium presence, carotid plaque presence, and carotid intima-media thickness for cardiovascular disease prediction in the multi-ethnic study of atherosclerosis

Adam D. Gepner, Rebekah Young, Joseph A. Delaney, Matthew C. Tattersall, Michael Blaha, Wendy S Post, Rebecca F Gottesman, Richard Kronmal, Matthew J. Budoff, Gregory L. Burke, Aaron R. Folsom, Kiang Liu, Joel Kaufman, James H. Stein

Research output: Contribution to journalArticle

Abstract

Background: Presence of coronary artery calcium (CAC), carotid plaque, and increased carotid intima-media thickness (IMT) may indicate elevated cardiovascular disease (CVD) risk; however, no large studies have compared them directly. This study compares predictive uses of CAC presence, carotid artery plaque presence, and high IMT for incident CVD events. Methods and Results: Participants were from the Multi-Ethnic Study of Atherosclerosis (MESA). Predictive values of carotid plaque, IMT, and CAC presence were compared using Cox proportional hazards models, c-statistics, and net reclassification indices. The 6779 participants were mean (SD) 62.2 (10.2) years old; 49.9% had CAC, and 46.7% had carotid plaque. The mean left and right IMT were 0.754 (0.210) mm and 0.751 (0.187) mm, respectively. After 9.5 years (mean), 538 CVD events, 388 coronary heart disease (CHD) events, and 196 stroke/transient ischemic attacks were observed. CAC presence was a stronger predictor of incident CVD and CHD than carotid ultrasound measures. Mean IMT ≥75th percentile (for age, sex, and race) alone did not predict events. Compared with traditional risk factors, c-statistics for CVD (c=0.756) and CHD (c=0.752) increased the most by the addition of CAC presence (CVD, 0.776; CHD, 0.784; P

Original languageEnglish (US)
Article numbere002262
JournalCirculation: Cardiovascular Imaging
Volume8
Issue number1
DOIs
StatePublished - 2014

Fingerprint

Carotid Intima-Media Thickness
Atherosclerosis
Coronary Vessels
Cardiovascular Diseases
Calcium
Coronary Disease
Carotid Stenosis
Transient Ischemic Attack
Proportional Hazards Models
Stroke

Keywords

  • Atherosclerosis
  • Cardiovascular disease
  • Carotid arteries
  • Neuroimaging
  • Risk factors

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

Comparison of coronary artery calcium presence, carotid plaque presence, and carotid intima-media thickness for cardiovascular disease prediction in the multi-ethnic study of atherosclerosis. / Gepner, Adam D.; Young, Rebekah; Delaney, Joseph A.; Tattersall, Matthew C.; Blaha, Michael; Post, Wendy S; Gottesman, Rebecca F; Kronmal, Richard; Budoff, Matthew J.; Burke, Gregory L.; Folsom, Aaron R.; Liu, Kiang; Kaufman, Joel; Stein, James H.

In: Circulation: Cardiovascular Imaging, Vol. 8, No. 1, e002262, 2014.

Research output: Contribution to journalArticle

Gepner, Adam D. ; Young, Rebekah ; Delaney, Joseph A. ; Tattersall, Matthew C. ; Blaha, Michael ; Post, Wendy S ; Gottesman, Rebecca F ; Kronmal, Richard ; Budoff, Matthew J. ; Burke, Gregory L. ; Folsom, Aaron R. ; Liu, Kiang ; Kaufman, Joel ; Stein, James H. / Comparison of coronary artery calcium presence, carotid plaque presence, and carotid intima-media thickness for cardiovascular disease prediction in the multi-ethnic study of atherosclerosis. In: Circulation: Cardiovascular Imaging. 2014 ; Vol. 8, No. 1.
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T1 - Comparison of coronary artery calcium presence, carotid plaque presence, and carotid intima-media thickness for cardiovascular disease prediction in the multi-ethnic study of atherosclerosis

AU - Gepner, Adam D.

AU - Young, Rebekah

AU - Delaney, Joseph A.

AU - Tattersall, Matthew C.

AU - Blaha, Michael

AU - Post, Wendy S

AU - Gottesman, Rebecca F

AU - Kronmal, Richard

AU - Budoff, Matthew J.

AU - Burke, Gregory L.

AU - Folsom, Aaron R.

AU - Liu, Kiang

AU - Kaufman, Joel

AU - Stein, James H.

PY - 2014

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N2 - Background: Presence of coronary artery calcium (CAC), carotid plaque, and increased carotid intima-media thickness (IMT) may indicate elevated cardiovascular disease (CVD) risk; however, no large studies have compared them directly. This study compares predictive uses of CAC presence, carotid artery plaque presence, and high IMT for incident CVD events. Methods and Results: Participants were from the Multi-Ethnic Study of Atherosclerosis (MESA). Predictive values of carotid plaque, IMT, and CAC presence were compared using Cox proportional hazards models, c-statistics, and net reclassification indices. The 6779 participants were mean (SD) 62.2 (10.2) years old; 49.9% had CAC, and 46.7% had carotid plaque. The mean left and right IMT were 0.754 (0.210) mm and 0.751 (0.187) mm, respectively. After 9.5 years (mean), 538 CVD events, 388 coronary heart disease (CHD) events, and 196 stroke/transient ischemic attacks were observed. CAC presence was a stronger predictor of incident CVD and CHD than carotid ultrasound measures. Mean IMT ≥75th percentile (for age, sex, and race) alone did not predict events. Compared with traditional risk factors, c-statistics for CVD (c=0.756) and CHD (c=0.752) increased the most by the addition of CAC presence (CVD, 0.776; CHD, 0.784; P

AB - Background: Presence of coronary artery calcium (CAC), carotid plaque, and increased carotid intima-media thickness (IMT) may indicate elevated cardiovascular disease (CVD) risk; however, no large studies have compared them directly. This study compares predictive uses of CAC presence, carotid artery plaque presence, and high IMT for incident CVD events. Methods and Results: Participants were from the Multi-Ethnic Study of Atherosclerosis (MESA). Predictive values of carotid plaque, IMT, and CAC presence were compared using Cox proportional hazards models, c-statistics, and net reclassification indices. The 6779 participants were mean (SD) 62.2 (10.2) years old; 49.9% had CAC, and 46.7% had carotid plaque. The mean left and right IMT were 0.754 (0.210) mm and 0.751 (0.187) mm, respectively. After 9.5 years (mean), 538 CVD events, 388 coronary heart disease (CHD) events, and 196 stroke/transient ischemic attacks were observed. CAC presence was a stronger predictor of incident CVD and CHD than carotid ultrasound measures. Mean IMT ≥75th percentile (for age, sex, and race) alone did not predict events. Compared with traditional risk factors, c-statistics for CVD (c=0.756) and CHD (c=0.752) increased the most by the addition of CAC presence (CVD, 0.776; CHD, 0.784; P

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KW - Cardiovascular disease

KW - Carotid arteries

KW - Neuroimaging

KW - Risk factors

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