BACKGROUND: Coronary artery calcium (CAC) and carotid intima-media thickness (IMT) are noninvasive measures of atherosclerosis that consensus panels have recommended as possible additions to risk factor assessment for predicting the probability of cardiovascular disease (CVD) occurrence. Our objective was to assess whether maximum carotid IMT or CAC (Agatston score) is the better predictor of incident CVD. METHODS: A prospective cohort study of subjects aged 45 to 84 years in 4 ethnic groups, who were initially free of CVD (n = 6698) was performed, with standardized carotid IMT and CAC measures at baseline, in 6 field centers of the Multi-Ethnic Study of Atherosclerosis (MESA). The main outcome measure was the risk of incident CVD events (coronary heart disease, stroke, and fatal CVD) over a maximum of 5.3 years of follow-up. RESULTS: There were 222 CVD events during follow-up. Coronary artery calcium was associated more strongly than carotid IMT with the risk of incident CVD. After adjustment for each other (CAC score and IMT) and age, race, and sex [corrected], the hazard ratio of CVD increased 2.1-fold (95% confidence interval [CI], 1.8-2.5) for each 1-standard deviation (SD) increment of log-transformed CAC score, vs 1.3-fold (95% CI, 1.1-1.4) for each 1-SD increment of the maximum IMT. For coronary heart disease, the hazard ratios per 1-SD increment increased 2.5-fold (95% CI, 2.1-3.1) for CAC score and 1.2-fold (95% CI, 1.0-1.4) for IMT. A receiver operating characteristic curve analysis also suggested that CAC score was a better predictor of incident CVD than was IMT, with areas under the curve of 0.81 vs 0.78, respectively. CONCLUSION: Although whether and how to clinically use bioimaging tests of subclinical atherosclerosis remains a topic of debate, this study found that CAC score is a better predictor of subsequent CVD events than carotid IMT.
BACKGROUND: Coronary artery calcium (CAC) and carotid intima-media thickness (IMT) are noninvasive measures of atherosclerosis that consensus panels have recommended as possible additions to risk factor assessment for predicting the probability of cardiovascular disease (CVD) occurrence. Our objective was to assess whether maximum carotid IMT or CAC (Agatston score) is the better predictor of incident CVD. METHODS: A prospective cohort study of subjects aged 45 to 84 years in 4 ethnic groups, who were initially free of CVD (n = 6698) was performed, with standardized carotid IMT and CAC measures at baseline, in 6 field centers of the Multi-Ethnic Study of Atherosclerosis (MESA). The main outcome measure was the risk of incident CVD events (coronary heart disease, stroke, and fatal CVD) over a maximum of 5.3 years of follow-up. RESULTS: There were 222 CVD events during follow-up. Coronary artery calcium was associated more strongly than carotid IMT with the risk of incident CVD. After adjustment for each other (CAC score and IMT) and age, race, and sex [corrected], the hazard ratio of CVD increased 2.1-fold (95% confidence interval [CI], 1.8-2.5) for each 1-standard deviation (SD) increment of log-transformed CAC score, vs 1.3-fold (95% CI, 1.1-1.4) for each 1-SD increment of the maximum IMT. For coronary heart disease, the hazard ratios per 1-SD increment increased 2.5-fold (95% CI, 2.1-3.1) for CAC score and 1.2-fold (95% CI, 1.0-1.4) for IMT. A receiver operating characteristic curve analysis also suggested that CAC score was a better predictor of incident CVD than was IMT, with areas under the curve of 0.81 vs 0.78, respectively. CONCLUSION: Although whether and how to clinically use bioimaging tests of subclinical atherosclerosis remains a topic of debate, this study found that CAC score is a better predictor of subsequent CVD events than carotid IMT.
Authors: Lynne E Wagenknecht; Carl D Langefeld; J Jeffrey Carr; Ward Riley; Barry I Freedman; Shahriar Moossavi; Donald W Bowden Journal: Stroke Date: 2004-04-08 Impact factor: 7.914
Authors: Hok-Hay S Oei; Rozemarijn Vliegenthart; A Elisabeth Hak; Antonio Iglesias del Sol; Albert Hofman; Matthijs Oudkerk; Jacqueline C M Witteman Journal: J Am Coll Cardiol Date: 2002-06-05 Impact factor: 24.094
Authors: Anne B Newman; Barbara L Naydeck; Kim Sutton-Tyrrell; Daniel Edmundowicz; Daniel O'Leary; Richard Kronmal; Gregory L Burke; Lewis H Kuller Journal: Arterioscler Thromb Vasc Biol Date: 2002-10-01 Impact factor: 8.311
Authors: D H O'Leary; J F Polak; S K Wolfson; M G Bond; W Bommer; S Sheth; B M Psaty; A R Sharrett; T A Manolio Journal: Stroke Date: 1991-09 Impact factor: 7.914
Authors: Irene M van der Meer; Michiel L Bots; Albert Hofman; Antonio Iglesias del Sol; Deirdre A M van der Kuip; Jacqueline C M Witteman Journal: Circulation Date: 2004-03-01 Impact factor: 29.690
Authors: Diane E Bild; David A Bluemke; Gregory L Burke; Robert Detrano; Ana V Diez Roux; Aaron R Folsom; Philip Greenland; David R Jacob; Richard Kronmal; Kiang Liu; Jennifer Clark Nelson; Daniel O'Leary; Mohammed F Saad; Steven Shea; Moyses Szklo; Russell P Tracy Journal: Am J Epidemiol Date: 2002-11-01 Impact factor: 4.897
Authors: Véronique L Roger; Alan S Go; Donald M Lloyd-Jones; Emelia J Benjamin; Jarett D Berry; William B Borden; Dawn M Bravata; Shifan Dai; Earl S Ford; Caroline S Fox; Heather J Fullerton; Cathleen Gillespie; Susan M Hailpern; John A Heit; Virginia J Howard; Brett M Kissela; Steven J Kittner; Daniel T Lackland; Judith H Lichtman; Lynda D Lisabeth; Diane M Makuc; Gregory M Marcus; Ariane Marelli; David B Matchar; Claudia S Moy; Dariush Mozaffarian; Michael E Mussolino; Graham Nichol; Nina P Paynter; Elsayed Z Soliman; Paul D Sorlie; Nona Sotoodehnia; Tanya N Turan; Salim S Virani; Nathan D Wong; Daniel Woo; Melanie B Turner Journal: Circulation Date: 2011-12-15 Impact factor: 29.690
Authors: Scott M Lilly; David R Jacobs; Richard Kronmal; David A Bluemke; Michael Criqui; Joao Lima; Matthew Allison; Daniel Duprez; Patrick Segers; Julio A Chirinos Journal: Atherosclerosis Date: 2014-02-12 Impact factor: 5.162
Authors: William G Sanders; Huan Li; Ilya Zhuplatov; Yuxia He; Seong-Eun Kim; Alfred K Cheung; Jayant Agarwal; Christi M Terry Journal: J Control Release Date: 2017-09-01 Impact factor: 9.776
Authors: Toni I Pollin; Coleen M Damcott; Haiqing Shen; Sandra H Ott; John Shelton; Richard B Horenstein; Wendy Post; John C McLenithan; Lawrence F Bielak; Patricia A Peyser; Braxton D Mitchell; Michael Miller; Jeffrey R O'Connell; Alan R Shuldiner Journal: Science Date: 2008-12-12 Impact factor: 47.728
Authors: Laura M Raffield; Subhashish Agarwal; Amanda J Cox; Fang-Chi Hsu; J Jeffrey Carr; Barry I Freedman; Jianzhao Xu; Donald W Bowden; Mara Z Vitolins Journal: Am J Clin Nutr Date: 2014-08-06 Impact factor: 7.045
Authors: Anandita Agarwala; Salim Virani; David Couper; Lloyd Chambless; Eric Boerwinkle; Brad C Astor; Ron C Hoogeveen; Joe Coresh; A Richey Sharrett; Aaron R Folsom; Tom Mosley; Christie M Ballantyne; Vijay Nambi Journal: Atherosclerosis Date: 2016-08-25 Impact factor: 5.162