(HealthDay News) — Coronary artery calcium (CAC) risk score is a better predictor of coronary heart disease (CHD) than stroke, according to a study published online in Circulation: Cardiovascular Imaging.
Anurag Mehta, MD, from Emory University in Atlanta, and colleagues evaluated the predictive value of CAC categories for CHD and stroke among 7042 White, Black, and Hispanic participants of the Multi-Ethnic Study of Atherosclerosis and Dallas Heart Study. Participants (mean age, 57 years; 54% women; 36% Black and 23% Hispanic) underwent CAC measurement at enrollment and were followed for incident atherosclerotic cardiovascular disease (ASCVD) events.
The researchers identified 574 incident ASCVD events (333 CHD and 241 stroke) during 12.3 years of follow-up. Among both men and women and among all races, the 10-year CHD-to-stroke incidence ratio increased significantly. There was an independent association noted for high CAC burden (score ≥100) with ASCVD and CHD risk in all groups and with stroke risk among the overall cohort and Black participants. There were no sex- or race-based CAC interactions for ASCVD, CHD, or stroke events. Risk discrimination and reclassification for CHD events, but not stroke, were improved by adding CAC to a traditional risk factor model.
“These nuances are important for guiding the patient-clinician shared decision-making process for deciding when to obtain a CAC scan and how to utilize CAC results to mitigate the risk of preventable CHD and stroke events,” the authors write.
One author reported financial ties to the pharmaceutical industry.
Mehta A, Pandey A, Ayers CR, et al. Predictive Value of Coronary Artery Calcium Score Categories for Coronary Events Versus Strokes: Impact of Sex and Race: MESA and DHS. Circ: Card Imag. doi:10.1161/CIRCIMAGING.119.010153