Carotid Intima-Media Thickness and Presence or Absence of Plaque Improves Prediction of Coronary Heart Disease Risk: The ARIC (Atherosclerosis Risk In Communities) Study

摘要: Objectives We evaluated whether carotid intima-media thickness (CIMT) and the presence or absence of plaque improved coronary heart disease (CHD) risk prediction when added to traditional factors (TRF). Background Traditional CHD schemes need further improvement as majority events occur in “low” “intermediate” groups. On an ultrasound scan, CIMT are associated with CHD, therefore could potentially help improve prediction. Methods Risk models (overall, men women) considered included TRF only, plus CIMT, plaque, plaque. Model predictivity was determined by calculating area under receiver-operating characteristic curve (AUC) adjusted for optimism. Cox proportional hazards were used estimate 10-year each model, number subjects reclassified determined. Observed compared expected events, net reclassification index calculated. Results Of 13,145 eligible (5,682 men, 7,463 women), ∼23% adding information. Overall, model provided most AUC, which increased from 0.742 (TRF only) 0.755 (95% confidence interval difference AUC: 0.008 0.017) overall sample. Similarly, had best 9.9% population. Sex-specific analyses presented manuscript. Conclusions Adding improves ARIC (Atherosclerosis In Communities) study.