Coronary artery calcification compared with carotid intima-media thickness in the prediction of cardiovascular disease incidence: the Multi-Ethnic Study of Atherosclerosis (MESA).

Description

Investigators of the Multi-Ethnic Study of Atherosclerosis (MESA) sought to determine the best predictor of incident cardiovascular disease (CVD) between coronary artery calcification (CAC) and carotid intima-media thickness (cIMT). The MESA is a prospective cohort study of 6,698 men and women 45 to 84 years of age from four ethnic groups. In this report, the maximum follow-up period was 5.3 years and 222 CVD events occurred during that period. Compared to participants in the bottom 50th percentile of cIMT, participants above the 75th percentile had an age, race, and sex-adjusted hazard ratio (HR) for incident CVD of 2.2 (95% CI, 1.5-3.2). Compared to participants in the bottom 50th percentile of CAC, participants above the 75th percentile had an age, race, and sex-adjusted HR for incident CVD of 5.3 (95% CI, 3.4-8.2). For incident coronary heart disease (CHD), the HRs were 2.1 (95% CI, 1.4-3.3) and 10.3 (95% CI, 5.6-18.9), respectively, for cIMT and CAC. Finally, for incident stroke, the HRs were 2.4 (95% CI, 1.2-4.7) and 1.2 (95% CI, 0.6-2.4), respectively, for cIMT and CAC. Although cIMT was found to be a better predictor of incident stroke in MESA, the authors concluded that CAC may be a better choice than cIMT as it showed stronger associations with both CVD and CHD.