Coronary artery calcium (CAC) score categories were associated with a significantly higher 10-year CHD-to-stroke incidence ratio as scores increased across all sex and race groups (P<0.001).
Cohort (n=7,042)
Yes
Does coronary artery calcium score category predict incident coronary heart disease versus stroke differently across sex and race groups in asymptomatic individuals?
p-value: p=<0.001
Background: Coronary 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. Methods: White, 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. Results: Among 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 <0.001). High CAC burden (score ≥100) was independently associated with ASCVD and CHD risk in all groups and with stroke risk in the overall cohort and Blacks. No sex- or race-based CAC interactions for ASCVD, CHD, and stroke events were observed. Adding CAC to a traditional risk factor model improved risk discrimination and reclassification for CHD but not for stroke events. Conclusions: In 2 population-based cohorts of asymptomatic individuals, 10-year CHD-to-stroke incidence ratio was higher with increasing CAC score categories across sex and race groups, and CAC was consistently a better predictor of CHD than stroke. High CAC burden comparably associated with ASCVD risk across sex and race groups.
Mehta et al. (Sat,) conducted a cohort in Asymptomatic individuals (n=7,042). Coronary artery calcium (CAC) score vs. CAC=0 vs 1-99 vs ≥100 was evaluated on 10-year CHD-to-stroke incidence ratio (p=<0.001). Coronary artery calcium (CAC) score categories were associated with a significantly higher 10-year CHD-to-stroke incidence ratio as scores increased across all sex and race groups (P<0.001).