Author + information
- Aferdita Spahillaria,b,
- Stanford Mwasongwea,b,
- John Carra,b,
- James Terrya,b,
- Robert Mentza,b,
- Daniel Addisona,b,
- Udo Hoffmanna,b,
- Jared Reisa,b,
- Jane Freedmana,b,
- Joao Limaa,b,
- Adolfo Correaa,b,
- Venkatesh Murthya,b and
- Ravi Shaha,b
Background: Efforts to refine statin eligibility via coronary calcification have been studied in Caucasians, but not in large African American populations.
Methods: In 1790 African Americans without prevalent cardiovascular disease (CVD) who underwent computed tomography, we compared the effectiveness of ACC/AHA guidelines relative to ATP-III in identifying participants with incident CVD (myocardial infarction, ischemic stroke, or CVD death) and non-zero coronary artery calcium (CAC).
Results: Mean age was 55.4 years (65% female). Statin eligibility by ACC/AHA guidelines identified 70% of African Americans with non-zero CAC (vs. 40% by ATP-III, P<0.0001) with improved discrimination and reclassification for the presence of CAC. Among individuals who were statin eligible by ACC/AHA guidelines, the 10-year CVD incidence per 1000 person-years was 8.3 (95% CI 6.1-11.2) in the presence of CAC and 3.0 (95% CI 1.6-5.8) without CAC (P=0.01). African Americans who were not ACC/AHA-statin eligible experienced a low CVD event rate of 0.9/1000 person-years regardless of CAC.
Conclusions: Statin eligibility by contemporary ACC/AHA guidelines is more effective at identifying subclinical high-risk vascular phenotypes relative to ATP-III. Statin ineligible African Americans are at low risk regardless of CAC status. CAC may further inform risk in statin eligible African Americans, suggesting complementary clinical and imaging approaches to further CVD risk.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Innovations in Cardiovascular Risk Assessment and Reduction
Abstract Category: 32. Prevention: Clinical
Presentation Number: 1235-059
- 2017 American College of Cardiology Foundation