Several studies have compared various techniques for risk stratification, including both CAC and CRP. Four studies comparing predictive abilities of hsCRP to CAC have demonstrated that CAC remains an independent predictor of cardiovascular events in multivariable models, while CRP no longer retains a significant association with incident CHD.
This has been confirmed recently in the MESA trial, which found that CAC score is a better predictor of subsequent cardiovascular disease events than CRP and carotid intima–media thickness (IMT). Carotid IMT is another measure of atherosclerosis and is also considered to be a nontraditional risk factor. Characteristics of carotid atherosclerosis have been associated with cardiovascular disease events, such as cerebral stroke and myocardial infarction. Multivariable analysis revealed hazard ratios for CHD were 1.7 (1.1–2.7) for carotid IMT and 8.2 (4.5–15.1) for a CAC score.
