Relationship between 10- and 30-year PREVENT risk scores with coronary artery calcium and incident atherosclerotic cardiovascular disease: MESA
Year: 2025
Type: article
Abstract: AIMS: The 2023 American Heart Association Predicting Risk of Cardiovascular Disease (CVD) EVENTs (PREVENT) risk equations allow for 10- and 30-year atherosclerotic CVD (ASCVD) quantitative risk assessment. We investigated the relationship between PREVENT 10-year and 30-year ASCVD risk categories with coronary artery calcium (CAC) and incident ASCVD. METHODS: This analysis included participants from the Multi-Ethnic Study of Atherosclerosis with CAC measured by computed tomography and calculated PREVENT (N=6,747) risk score. Prevalent, incident, and CAC progression, as well as incident ASCVD, were compared by clinical 10-year risk categories and 30-year risk cut points based on a framework categorizing lifetime risk of ASCVD; low risk was defined as < the mean 30 year PREVENT estimate for participants without ASCVD risk factors (<11%). RESULTS: The cohort mean age was 62.2 years and was 52.8% female, and 61.5% non-White. Individuals with low 10-year PREVENT ASCVD risk (<5%) and elevated PREVENT 30-year ASCVD risk (≥11%) had a higher prevalence of CAC compared to those low-risk for both 10-year and 30-year metrics. Incident CAC followed a similar pattern. CAC progression was similar across risk thresholds for both risk equations. Individuals with low 10 -year PREVENT risk but elevated 30-year risk had a higher incidence of ASCVD events compared to those with those low by both metrics [hazard ratio 2.21; 95% confidence interval (1.62, 2.94)]. CONCLUSION: Individuals with low 10-year PREVENT ASCVD predicted risk (<5%) may benefit from 30-year ASCVD risk estimation when uncertainty remains regarding further risk stratification or initiation of preventive therapies.
Language: English
Subfield: Radiology, Nuclear Medicine and Imaging
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,792
Awards: MESA, G1409423729, G1539384734, G1686417863, G1803853571, G2262782284, MESA, G2580996367, MESA, SUBCLINICAL CARDIOVASCULAR DISEASE STUDY--EBCT READING, G3570589137, G3647016462, G3687594596, G370977179, MESA, G399481048, TITLE: MULTI-ETHNIC STUDY OF ATHEROSCLEROSIS (MESA), G4512137732, G4563812999, OPTION 3. 4/1/2014 - 3/31/2015. MULTI-ETHNIC STUDY OF ATHEROSCLEROSIS (MESA) - READING CENTER, NHLBI, MESA, G5088122703, G5108002584, G514410172, SUBCLINICAL CARDIOVASCULAR DISEASE STUDY-ULTRASOUND, G5787256936, G6095866717, G6359107525, Institute for Clinical and Translational Research, MESA, G6514094751, MESA, Clinical and Translational Science Award, G8761005068, G94668252
OpenAlex ID: W4417458425