1. Predictive Value of Coronary Artery Calcium Score Categories for Coronary Events Versus Strokes: Impact of Sex and Race: MESA and DHS
- Author
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Mehta, Anurag, Pandey, Ambarish, Ayers, Colby R, Khera, Amit, Sperling, Laurence S, Szklo, Moyses S, Gottesman, Rebecca F, Budoff, Mathew J, Blaha, Michael J, Blumenthal, Roger S, Nasir, Khurram, and Joshi, Parag H
- Subjects
Adult ,Male ,Aging ,Time Factors ,Clinical Sciences ,Coronary Disease ,Comorbidity ,Cardiovascular ,Severity of Illness Index ,Risk Assessment ,Sex Factors ,Predictive Value of Tests ,Clinical Research ,cardiovascular disease ,80 and over ,Humans ,cardiovascular diseases ,Vascular Calcification ,Heart Disease - Coronary Heart Disease ,Aged ,risk ,calcium ,Incidence ,Prevention ,nutritional and metabolic diseases ,Middle Aged ,stroke ,United States ,Race Factors ,Brain Disorders ,Heart Disease ,Cardiovascular System & Hematology ,Heart Disease Risk Factors ,cardiovascular system ,population characteristics ,Female ,Patient Safety ,atherosclerosis ,coronary artery disease - Abstract
BackgroundCoronary artery calcium (CAC) predicts atherosclerotic cardiovascular disease (ASCVD) events, inclusive of coronary heart disease (CHD) and stroke, and is a decision-making aid for primary prevention. The predictive value of CAC categories for CHD and stroke separately and across sex and race groups of an asymptomatic population is unclear.MethodsWhite, Black, and Hispanic participants of MESA (Multi-Ethnic Study of Atherosclerosis) and DHS (Dallas Heart Study) underwent CAC measurement at enrollment and were followed for incident ASCVD events. Ten-year CHD-to-stroke incidence ratios across CAC score categories 0, 1 to 99, and ≥100 were assessed. Associations of CAC with incident CHD and stroke events were evaluated using multivariable-adjusted Cox models and multiplicative interactions of CAC with sex/race were tested.ResultsAmong 7042 participants (mean age, 57 years, 54% women, 36% Black, 23% Hispanic, 49% CAC=0, 19% CAC ≥100), 574 incident ASCVD events (333 CHD and 241 stroke) were observed over 12.3-year follow-up. Ten-year CHD-to-stroke incidence ratio increased significantly across CAC categories in men, women, Whites, Blacks, and Hispanics (all P
- Published
- 2020