TY  - BOOK
AU  - Taylor, Allen J
TI  - Multi-ethnic study of atherosclerosis arterial age versus framingham 10-year or lifetime cardiovascular risk
SN  - 0002-9149
PY  - 2012///
KW  - *Atherosclerosis/eh [Ethnology]
KW  - *Coronary Artery Disease/eh [Ethnology]
KW  - *Ethnic Groups
KW  - *Risk Assessment/mt [Methods]
KW  - Adult
KW  - Atherosclerosis/ra [Radiography]
KW  - Coronary Artery Disease/ra [Radiography]
KW  - Follow-Up Studies
KW  - Forecasting
KW  - Humans
KW  - Male
KW  - Middle Aged
KW  - Military Personnel
KW  - Prevalence
KW  - Prospective Studies
KW  - Risk Factors
KW  - ROC Curve
KW  - Tomography, X-Ray Computed
KW  - United States/ep [Epidemiology]
KW  - MedStar Heart & Vascular Institute
KW  - Comparative Study
KW  - Journal Article
N1  - Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006
N2  - Methods to improve coronary heart disease (CHD) risk prediction include incorporation of coronary artery calcium (CAC) within risk models and considering longer time horizons such as evaluation of lifetime cardiovascular risk (LTR). We compared the accuracy of 10-year Framingham risk score (FRS), LTR, and Multi-Ethnic Study of Atherosclerosis (MESA) arterial age-adjusted 10-year risk for prediction of incident CHD events in men in the Prospective Army Coronary Calcium Project. We studied 1,633 healthy men (mean age 43 years, range 40 to 50 years, mean FRS 4.6%) with electron-beam computed tomography for CAC. Events (CHD death, myocardial infarction, acute coronary syndrome with nonelective coronary revascularization) were prospectively assessed over 5.6 +/- 1.5 years. Predicted risk using 10-year FRS for CHD and cardiovascular disease, LTR, and MESA arterial age were evaluated in relation with CAC and CHD events. CAC prevalence was strongly related to LTR, increasing in a graded fashion from 10.1% to 66.7% across 8 categories of increasing LTR. On receiver operating characteristic analysis, MESA arterial age (area under curve 0.78, 95% confidence interval 0.64 to 0.93) had the largest area under the curve but similar areas under the curve were observed for 10-year risk (CHD 0.74, 0.61 to 0.86; cardiovascular disease 0.70, 0.59 to 0.82), LTR (0.68, 0.49 to 0.76), and LTR with CAC as a covariate (0.76, 0.63 to 0.89). Inclusion of family history of CHD or body mass index did not improve model accuracy. In conclusion, increasing LTR was associated with increasingly prevalent CAC in this low-risk cohort and inclusion of CAC improved the accuracy of LTR for short-term event prediction. Published by Elsevier Inc
UR  - http://dx.doi.org/10.1016/j.amjcard.2012.07.018
ER  -