Prevalence, Impact, and Predictive Value of  Detecting Subclinical Coronary and Carotid  XXXX in Asymptomatic Adults: The BioImage Study.

@entity1 @entity583 @entity951 @entity453 @entity299 @entity729 @entity731 @entity204 @entity65 @entity385
BACKGROUND: Although recent studies suggest that measuring @entity729 ( @entity729 ) may be superior to  indirect atherosclerotic markers in predicting cardiac risk, there are limited data evaluating imaging-based biomarkers that directly quantify @entity731 in different vascular beds performed in a single cohort. OBJECTIVES: The BioImage Study (A Clinical Study of Burden of @entity731 in  an At-Risk Population) sought to identify imaging biomarkers that predict near-term (3-year) atherothrombotic events. METHODS: The BioImage Study enrolled 5,808 asymptomatic U.S. adults (mean age: 69 years, 56.5% female) in a prospective cohort evaluating the role of vascular imaging on cardiovascular risk prediction. All @entity1 were evaluated by @entity729 and novel 3-dimensional carotid ultrasound. Plaque areas from both carotid arteries were summed as the carotid plaque burden (cPB). The primary endpoint was the composite of major adverse @entity299 (MACE) ( @entity65 , @entity583 , and @entity385 ). A broader secondary MACE endpoint also included all-cause @entity204 , unstable @entity951 , and coronary revascularization. RESULTS: Over a median follow-up of 2.7 years, MACE occurred in 216 @entity1 (4.2%), of which 82 (1.5%) were primary events. After adjustment for risk  factors, and compared with individuals without any cPB, hazard ratios for MACE were 0.78 (95% confidence interval [CI]: 0.31 to 1.91), 1.45 (95% CI: 0.67 to 3.14), and 2.36 (95% CI: 1.13 to 4.92) with increasing cPB tertile, with similar results for @entity729 . Net  reclassification significantly improved with either cPB (0.23) or @entity729 (0.25). MACE rates increased simultaneously with higher levels of both cPB and @entity729 . CONCLUSIONS: Detection of subclinical carotid or @entity453 improves risk predictions and reclassification compared with conventional risk factors, with comparable results for either modality. Cost-effective analyses are warranted to define the optimal roles of these complementary techniques. (BioImage Study: A Clinical Study of Burden of  @entity731 in an At-Risk Population; NCT00738725).
