New Pooled Cohort Risk Equations and Presence of Asymptomatic Brain Infarction

Abstract

Background and Purpose— The new pooled cohort risk (PCR) equations is sex- and race-specific estimates of the 10-year risk of atherosclerotic cardiovascular events among disease-free adults. Little is known about the association between the PCR model and presence of silent brain infarction (SBI). Methods— We conducted a cross-sectional study of 1603 neurologically asymptomatic Korean people (mean age, 56.6±8.3; 838 men), who underwent brain MRI. We explored the association of PCR with SBI by race. SBI was divided into deep subcortical and hemispheric (hs-SBI). Results— One-hundred seventy-five (10.9%) subjects had SBI. The PCR as white was independently related to the presence of SBI (odds ratio, 1.06; 95% confidence interval, 1.04–1.09), multiple (≥2) SBIs (1.09; 1.05–1.12), deep subcortical SBI (1.06; 1.04–1.09), and hs-SBI (1.07; 1.02–1.11). Compared with the lowest PCR category (<5%), dose–response relationships were observed between increasing category (5% to <7.5%, 7.5% to <10%, and ≥10%) and the presence of SBI, respectively (1.85, 0.91–3.74; 2.41, 1.13–5.14; and 3.76, 2.17–6.52), multiple SBIs (0.88, 0.10–8.02; 8.44, 2.29–31.11; and 8.47, 2.66–27.02), deep subcortical SBI (1.92, 0.92–4.02; 2.46, 1.11–4.45; and 3.77, 2.11–6.74), and hs-SBI (1.20, 0.12–11.81; 5.59, 1.08–28.96; and 5.96, 1.46–24.38). C-statistic of PCR category for SBI was 0.63 (0.60−0.65); multiple SBIs, 0.71 (0.69−0.73); deep subcortical SBI, 0.62 (0.60−0.65); and hs-SBI, 0.71 (0.68−0.73). Calibration as black showed similar pattern to findings from white model. Conclusions— Discrimination was fairly compatible with each race model. The PCR might serve as a simple clinical tool for identifying people at high risk for the untoward consequences of SBI, particularly multiple SBIs and hs-SBI.