%0 Journal Article
%T Coronary artery calcium and carotid artery intima
%A Indre Ceponiene
%A James H Stein
%A John W McEvoy
%A Joseph F Polak
%A Kazuhiro Osawa
%A Maria Esther Perez Trejo
%A Matthew J Budoff
%A Michael J Blaha
%A Ralph L Sacco
%A Rine Nakanishi
%A Robyn L McClelland
%A Ron Blankstein
%J European Journal of Preventive Cardiology
%@ 2047-4881
%D 2018
%R 10.1177/2047487318798058
%X Current guidelines suggest treatment for many individuals who may never develop a stroke. We hypothesized that a combination of coronary artery calcification (CAC) and carotid artery intima-media thickness (CIMT) data could better individualize risk assessment for ischemic stroke and transient ischemic attack events. A total of 4720 individuals from the Multi-Ethnic Study of Atherosclerosis were evaluated for ischemic stroke and transient ischemic attack. Cox proportional hazards models for time to incident ischemic stroke/transient ischemic attack were used to examine CAC and CIMT as ischemic stroke/transient ischemic attack predictors in addition to traditional risk factors. We calculated the 10-year number needed to treat by applying the benefit observed in ASCOT-LLA to the observed event rates within CAC and CIMT strata. Median follow-up was 13.1 years. Compared with individuals with no CAC and with CIMT£¿¡Ü£¿75th percentile, stroke/transient ischemic attack risk increased progressively with each CAC category (0, 1¨C100, >100) among individuals with CIMT£¿>£¿75th percentile. Among participants eligible for statin therapy based on the 2013 atherosclerotic cardiovascular disease (ASCVD) guidelines (ASCVD risk of >5%), 739/2906 (25%) had no CAC and CIMT£¿¡Ü£¿75th percentile and an observed ischemic stroke/transient ischemic attack rate of 2.49 per 1000 person-years. The predicted 10-year number needed to treat was 292 for no CAC and CIMT£¿¡Ü£¿75th percentile and 57 for CAC£¿>£¿100 and CIMT£¿>£¿75th percentile. The combination of CIMT and CAC could serve to further refine risk calculation for ischemic stroke/transient ischemic attack prevention and may prioritize those in most need of statin therapy to reduce ischemic stroke/transient ischemic attack risk
%K Carotid artery intima-media thickness
%K ischemic stroke/transient ischemic attack
%K coronary artery calcification
%U https://journals.sagepub.com/doi/full/10.1177/2047487318798058