Abstract 18549: Value of Coronary Artery Calcium and Carotid IMT in Predicting Cardiovascular Disease Events among Individuals with Family History of Heart Disease: The Multi-Ethnic Study of Atherosclerosis.
Background: Individuals with a family history (FamHx) of CHD are more likely to have subclinical atherosclerosis than those without any FamHx; however, whether a higher atherosclerotic burden in these groups adds to coronary heart disease (CHD) risk prediction above and beyond traditional risk factor assessment is unclear.
Methods: MESA is a cohort study of men and women aged 45-84 years free of clinical cardiovascular disease at baseline. Detailed information on FH of CHD was obtained in 6201 individuals. We excluded 854 participants (13%) who did not know about the presence/absence or onset of the CHD event among their family members. Cox proportional hazard models adjusting for demographics and traditional risk factors were constructed to predict the end points of cumulative coronary heart disease (CHD) with increasing coronary artery calcium (CAC) scores and common carotid intimal thickness (CIMT) quartiles among those with and without FH of CHD.
Results: The final study population consisted of 5,347 individuals (61±10 years, 47% males). Overall, 2761 participants (42%; 1237 women) reported a FH of CHD. In a median follow-up of 5.8 years, 213 (4%) CHD events were noted. Multivariable Cox regression hazard ratios (HRs) and 95% confidence intervals (CI) for CHD events according to CAC and CIMT category, adjusted for demographics and traditional risk factors are presented in the table below. Increasing CAC scores was equally predictive of future CHD events in individuals with and without FH of CHD as no significant CAC-FH of CHD interaction was observed in our study (all p>0.25). Overall, CAC increased the c-statistic for CHD events (p<0.01) over these risk factors in both individuals with & without FH of CHD. On the other hand CIMT was weakly predictive of CHD events among those with FH of CHD (p=0.03 for trend across quartiles).
Conclusion: CHD risk prediction in those with FH of CHD is improved from evaluation of CAC and CIMT.
- © 2010 by American Heart Association, Inc.