BACKGROUND: Several studies have demonstrated the tremendous potential of using coronary artery @entity460 (CAC) in addition to traditional risk factors for @entity301 ( @entity301 ) risk prediction. However, to date, no risk score incorporating CAC has been developed. OBJECTIVES: The goal of this study was to derive and validate a novel risk score to estimate 10-year @entity301 risk using CAC and traditional risk factors. METHODS: Algorithm development was conducted in the MESA (Multi-Ethnic Study of @entity731 ), a prospective community-based cohort study of 6,814 @entity1 age 45 to 84 years, who were free of clinical @entity299 at baseline and followed for 10 years. MESA is sex balanced and included 39% non-Hispanic whites, 12% Chinese Americans, 28% African Americans, and 22% Hispanic Americans. External validation was conducted in the HNR (Heinz Nixdorf Recall Study) and the DHS (Dallas Heart Study). RESULTS: Inclusion of CAC in the MESA risk score offered significant improvements in risk prediction (C-statistic 0.80 vs. 0.75; p  < 0.0001). External validation in both the HNR and DHS studies provided evidence of very good discrimination and calibration. Harrell's C-statistic was 0.779 in HNR and 0.816 in DHS. Additionally, the difference in estimated 10-year risk between events and nonevents was approximately 8% to 9%, indicating excellent discrimination. Mean calibration, or calibration-in-the-large, was excellent for both studies, with average predicted 10-year risk within one-half of a percent of the observed event rate. CONCLUSIONS: An accurate estimate of 10-year @entity301 risk can be obtained using traditional risk factors and CAC. The  MESA risk score, which is available online on the MESA web site for easy use, can be used to aid clinicians when communicating risk to @entity1 and when determining risk-based treatment strategies.

10-Year Coronary Heart Disease Risk  Prediction Using Coronary Artery @entity460 and Traditional Risk Factors: Derivation in the MESA (Multi-Ethnic Study of XXXX ) With  Validation in the HNR (Heinz Nixdorf Recall) Study and the DHS (Dallas  Heart Study).

@entity1 :: ('9606', 'Species') :: ['participants', 'patients'] @entity301 :: ('MESH:D003327', 'Disease') :: ['CHD', 'coronary heart disease'] @entity460 :: ('MESH:D002118', 'Chemical') :: ['calcium'] @entity299 :: ('MESH:D006331', 'Disease') :: ['heart disease'] @entity731 :: ('MESH:D050197', 'Disease') :: ['Atherosclerosis']
@entity731 :: (MESH:D050197,Disease) :: ['Atherosclerosis']
