{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T02:50:36Z","timestamp":1790995836065,"version":"4.1.0"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2017,2,2]]},"abstract":"\n Background<\/jats:title>\n \n Coronary artery calcium (\n CAC<\/jats:styled-content>\n ) predicts coronary heart disease (\n CHD<\/jats:styled-content>\n ) events better than carotid wall plaque presence; however, differences in the utility of\n CAC<\/jats:styled-content>\n burden and carotid plaque burden across the spectrum of cardiovascular disease (\n CVD<\/jats:styled-content>\n ) events is unknown.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n CVD<\/jats:styled-content>\n ,\n CHD<\/jats:styled-content>\n and stroke\/transient ischemic attack (\n TIA<\/jats:styled-content>\n ) events were evaluated prospectively in a multiethnic cohort without\n CVD<\/jats:styled-content>\n at baseline. Carotid plaque score was determined by the number of ultrasound\u2010detected plaques in the common, bifurcation, and internal carotid artery segments.\n CAC<\/jats:styled-content>\n was detected by computed tomography. Predictive values were compared using Cox proportional hazards models, C\u2010statistics, and net reclassification, adjusting for traditional\n CVD<\/jats:styled-content>\n risk factors. At baseline, the 4955 participants were mean (SD) 61.6 (10.1) years old and 52.8% female; 48.9% had\n CAC<\/jats:styled-content>\n >0 and 50.8% had at least 1 carotid plaque. After 11.3 (3.0) years of follow\u2010up, 709\n CVD<\/jats:styled-content>\n , 498\n CHD<\/jats:styled-content>\n , and 262 stroke\/\n TIA<\/jats:styled-content>\n events occurred.\n CAC<\/jats:styled-content>\n score compared to carotid plaque score was a stronger predictor of\n CVD<\/jats:styled-content>\n (hazard ratio [\n HR<\/jats:styled-content>\n ], 1.78; 95%\n CI<\/jats:styled-content>\n , 1.16\u20131.98;\n P<\/jats:italic>\n <0.001 vs\n HR<\/jats:styled-content>\n , 1.27; 95%\n CI<\/jats:styled-content>\n , 1.16\u20131.40;\n P<\/jats:italic>\n <0.001) and\n CHD<\/jats:styled-content>\n events (\n HR<\/jats:styled-content>\n , 2.09; 95%\n CI<\/jats:styled-content>\n , 1.84\u20132.38;\n P<\/jats:italic>\n <0.001 vs\n HR<\/jats:styled-content>\n , 1.35; 95%\n CI<\/jats:styled-content>\n , 1.21\u20131.51;\n P<\/jats:italic>\n <0.001).\n CAC<\/jats:styled-content>\n score and carotid plaque score were weak predictors of stroke\/\n TIA<\/jats:styled-content>\n .\n CAC<\/jats:styled-content>\n score had better reclassification statistics than carotid plaque score, except for stroke\/\n TIA<\/jats:styled-content>\n , which had similar predictive values.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n CAC<\/jats:styled-content>\n score improved prediction, discrimination, and reclassification of\n CVD<\/jats:styled-content>\n and\n CHD<\/jats:styled-content>\n better than carotid ultrasound measures, although prediction and discrimination were similar for stroke\/\n TIA<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.116.005179","type":"journal-article","created":{"date-parts":[[2017,2,15]],"date-time":"2017-02-15T02:00:22Z","timestamp":1487124022000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":146,"title":["Comparison of Carotid Plaque Score and Coronary Artery Calcium Score for Predicting Cardiovascular Disease Events: The Multi\u2010Ethnic Study of Atherosclerosis"],"prefix":"10.1161","volume":"6","author":[{"given":"Adam D.","family":"Gepner","sequence":"first","affiliation":[{"name":"University of Wisconsin School of Medicine and Public Health, Madison, WI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebekah","family":"Young","sequence":"additional","affiliation":[{"name":"University of Washington, Seattle, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph A.","family":"Delaney","sequence":"additional","affiliation":[{"name":"University of Washington, Seattle, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew J.","family":"Budoff","sequence":"additional","affiliation":[{"name":"University of California\u2013Los Angeles, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph F.","family":"Polak","sequence":"additional","affiliation":[{"name":"Tufts Medical Center, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Blaha","sequence":"additional","affiliation":[{"name":"Johns Hopkins University, Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy S.","family":"Post","sequence":"additional","affiliation":[{"name":"Johns Hopkins University, Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin D.","family":"Michos","sequence":"additional","affiliation":[{"name":"Johns Hopkins University, Baltimore, MD"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel","family":"Kaufman","sequence":"additional","affiliation":[{"name":"University of Washington, Seattle, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James H.","family":"Stein","sequence":"additional","affiliation":[{"name":"University of Wisconsin School of Medicine and Public Health, Madison, WI"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/jaha.113.000180"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.08.035"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2015.02.006"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.9624"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.11.005"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2009.11.075"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.07.066"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.114.002262"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2012.11.008"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.111.678078"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2014.07.009"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.168.12.1333"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2007.07.075"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1161\/jaha.113.000087"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2011.06.044"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.1536\/ihj.53.154"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwf113"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2007.11.011"},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.1159\/000097034"},{"key":"e_1_3_5_21_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2341040439"},{"key":"e_1_3_5_22_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa072100"},{"key":"e_1_3_5_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(90)90282-T"},{"key":"e_1_3_5_24_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0258(19960229)15:4<361::AID-SIM168>3.0.CO;2-4"},{"key":"e_1_3_5_25_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.1.5288.1293"},{"key":"e_1_3_5_26_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2010.461"},{"key":"e_1_3_5_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2004.10.012"},{"key":"e_1_3_5_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2013.02.003"},{"key":"e_1_3_5_29_2","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jev222"},{"key":"e_1_3_5_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2015.02.010"},{"key":"e_1_3_5_31_2","doi-asserted-by":"publisher","DOI":"10.1002\/jcu.21996"}],"container-title":["Journal 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