OBJECTIVES: This study sought to assess the effect of coronary artery @entity460 (CAC) on @entity301 ( @entity301 )  risk prediction in a younger population. BACKGROUND: CAC measured by computed tomography improves @entity301 risk classification in older adults, but the effectiveness of CAC in younger populations has not been fully assessed. METHODS: In the DHS (Dallas Heart Study), a multiethnic probability-based population sample, traditional @entity301  risk  factors and CAC were measured in @entity1 without baseline @entity65 or @entity6 . Incident  @entity301 -defined as @entity301 death, @entity583 , or coronary revascularization-was assessed over  a  median follow-up of 9.2 years. Predicted @entity301 risk was assessed with a Weibull model inclusive of traditional  risk  factors before and after the addition of CAC as ln( @entity25346 ). @entity1 were divided into 3  10-year  risk  categories,  <6%,  6% to  <20%, and  >= 20%, and the net reclassification improvement (NRI) was  calculated.  We  also  performed a random-effects meta-analysis of NRI from previous studies inclusive of  older  individuals. RESULTS: The analysis comprised 2,084 @entity1 ; mean age was 44.4    9.0 years. CAC was independently associated with incident @entity301 (hazard ratio per SD: 1.90, 95% confidence interval [CI] 1.51 to 2.38; p  < 0.001). The  addition of CAC to the traditional risk factor model resulted in significant improvement in the C-statistic (delta  =  0.03; p  = 0.003). Among @entity1 with @entity301 events, the addition of CAC resulted in net correct upward  reclassification of 21%, and among those without @entity301 , a net correct downward reclassification of 0.5% (NRI:  0.216, p  = 0.012). Results remained significant when the outcome was restricted to @entity301 death and @entity583 and when individuals with @entity6 were included. The NRI observed in this study was similar to the pooled estimate from previous studies (0.200, 95% CI: 0.140 to 0.258) and the addition of our study to the meta-analysis did not result in significant heterogeneity (I(2)  = 0%). CONCLUSIONS: CAC scoring also improves @entity301 risk classification in younger adults.

Coronary Artery XXXX Improves Risk Classification in Younger Populations.

@entity1 :: ('9606', 'Species') :: ['participants', 'Participants'] @entity6 :: ('MESH:D003920', 'Disease') :: ['diabetes'] @entity301 :: ('MESH:D003327', 'Disease') :: ['CHD', 'coronary heart disease'] @entity25346 :: ('113452', 'Gene') :: ['CAC  + 1'] @entity460 :: ('MESH:D002118', 'Chemical') :: ['calcium'] @entity583 :: ('MESH:D009203', 'Disease') :: ['myocardial infarction'] @entity65 :: ('MESH:D002318', 'Disease') :: ['cardiovascular disease']
@entity460 :: (MESH:D002118,Chemical) :: ['Calcium']
