Carotid Intima-Media Thickness Versus Coronary Artery Calcium Score in Predicting Incident Coronary Heart Disease and Stroke Among African Americans: The Jackson Heart Study

Effoe, Valery; Bertoni, Alain G.; Yan, Fuhua; Taka, Nchang; Olanipekun, Titilope; Adedinsewo, Demilade; Fox, Ervin R.; Taylor, Herman A.

doi:10.1016/s0735-1097(18)32413-6

Cited by 2 publications

(4 citation statements)

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“…A total of five publications [7][8][9]15,16 were included in this review after exclusion of studies that did not meet the inclusion criteria (Figure 1). Thus, this review included 61,096 patients (the 4838 patients from the MESA study in Mehta 2022 7 were not included as MESA study was included in the Yano 2017 study 16 ) (Table 1).…”

Section: Resultsmentioning

confidence: 99%

“…There were additional results which could not be statistically pooled. The data from the Jackson Heart Study 9 suggest that there was an increase in incident stroke with CAC, but this was not statistically significant (adjusted hazard ratio [aHR] 1.18 95% CI 0.54–2.58). The predictive value of CAC and stroke had an area under the curve of 0.694 in the study by Singh et al 15 The confirmation studies which used European data from the RS and HNRS found minor reductions in incident stroke prediction comparing age as a predictor to CAC score 16 …”

Section: Resultsmentioning

confidence: 99%

“…The Walter Reed Study of young adults reported a significant increase in incident stroke for patients with CAC >100 compared with those without CAC 8 . Furthermore, data from the Jackson Heart Study suggests that CAC is associated with increased odds of incident stroke, but this was not statistically significant 9 . The only meta‐analysis on CAC and incident stroke to date included three studies, which followed up patients for 7.2 years and found that the presence and severity of CAC were associated with incident stroke over mid‐long‐term follow‐up 10 .…”

Section: Introductionmentioning

confidence: 97%

“…8 Furthermore, data from the Jackson Heart Study suggests that CAC is associated with increased odds of incident stroke, but this was not statistically significant. 9 The only meta-analysis on CAC and incident stroke to date included three studies, which followed up patients for 7.2 years and found that the presence and severity of CAC were associated with incident stroke over midlong-term follow-up. 10 In addition to newer studies being published, the main limitation of this review was that the study pooled crude risk ratios, and they did not consider different cut-offs for CAC score.…”

Section: Introductionmentioning

confidence: 99%

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Coronary artery calcium score and its association with stroke: A systematic review and meta‐analysis

Kwok

Bennett

Lip

2022

Eur J Clin Investigation

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Background The relationship between coronary artery calcium (CAC) score and incident stroke is controversial. Methods We conducted a systematic review of the literature evaluating CAC score and incident stroke. A search of MEDLINE and EMBASE was performed, and data were extracted from relevant studies. Statistical pooling with random‐effects meta‐analysis was undertaken to evaluate the risk of incident stroke with any CAC vs. no CAC, 1–100 CAC vs. no CAC, and >100 CAC vs. no CAC. Results Data from nine different cohort studies from the United States and Europe with a total of 61,096 patients were included in this review. The mean age of patients in the studies ranged from 44 to 69 years, and follow‐up duration ranged from a median of 5.5 years to 12.3 years. The crude stroke event varied from 1.6% to 9.5%. Meta‐analysis of risk of incident stroke with any vs. no CAC (RR 1.70 95% CI 0.87–3.31, I2 = 95%) and for CAC 1–100 vs. no CAC (RR 1.54 95% CI 0.75–3.17, I2 = 93%) was not statistically significant. For CAC >100, the risk of incident stroke was significantly higher compared with no CAC (RR 2.61 95% CI 1.51–4.52, I2 = 89%). When one study which included only young adults was excluded, there was significant increase in risk of incident stroke with all categories of CAC. Conclusions There is an association between high CAC score and incident stroke, but more studies are needed to determine how patients with incidental CAC should be managed from the perspective of stroke prevention.

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