{
  "abstract": "Background: Carotid plaque burden is an established cardiovascular risk marker, but the incremental predictive value of a simplified six-segment plaque score within a multivariable model remains less well characterized in hospital-based Chinese primary-prevention populations. We aimed to develop and internally validate a 5-year model for major adverse cardiovascular and cerebrovascular events (MACE) incorporating this score.\n\nMethods: This single-center retrospective cohort included adults aged ≥40 years without prior clinical cardiovascular or cerebrovascular disease who underwent bilateral carotid ultrasonography between 2015 and 2020. Plaque presence in six carotid segments generated a 0–6 score. The primary outcome was 5-year hard MACE, defined as cardiovascular death, nonfatal myocardial infarction, or nonfatal ischemic stroke. Three Cox models were compared: clinical predictors alone, clinical predictors plus binary plaque presence, and clinical predictors plus plaque score. Performance was assessed by discrimination, calibration, Brier score, decision curve analysis, and 1,000 bootstrap resamples.\n\nResults: Among 2,413 patients, 1,560 (64.6%) had carotid plaque and 108 experienced hard MACE during a median follow-up of 4.92 years. Five-year MACE incidence increased from 1.5% for plaque scores 0–1 to 6.1% for scores 2–4 and 15.4% for scores 5–6 ( P < 0.001). Each 1-point score increase was associated with higher MACE risk (HR, 1.32; 95% CI, 1.21–1.44). The apparent C-index increased from 0.753 for the clinical model to 0.804 with the plaque score; the corresponding 5-year AUC and Brier score were 0.807 and 0.0381. After bootstrap correction, the C-index was 0.792 and calibration slope 0.93. Model 3 showed greater net benefit across most 2%–10% thresholds, with broadly similar findings in sensitivity analyses.\n\nConclusions: In this hospital-based primary-prevention cohort, the simplified six-segment carotid plaque score provided incremental predictive information beyond conventional clinical factors and binary plaque presence. External validation, particularly in lower-risk community and primary-care populations, is required before broader clinical application.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Ultrasound, Cardiovascular and Cerebrovascular Disease Hospital, General Hospital of Ningxia Medical University"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 3,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Haitao Hu"
    },
    {
      "affs": [
        0
      ],
      "name": "Daoyan Li"
    },
    {
      "affs": [
        0
      ],
      "name": "Qian Zhang"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/3eh1cdgw7w1rg.bib",
  "cited_by": 0,
  "doi": "10.3389/fcvm.2026.1966647",
  "fulltext_url": null,
  "id": "3eh1cdgw7w1rg",
  "issns": [
    "2297-055X"
  ],
  "landing_url": "https://www.frontiersin.org/articles/10.3389/fcvm.2026.1966647/full",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2740|Cerebrovascular and Carotid Artery Diseases"
    ]
  ],
  "openalex": "W7224104961",
  "pdf_url": "https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2026.1966647/pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-28",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/3eh1cdgw7w1rg.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:10Z",
      "native_id": "10.3389/fcvm.2026.1966647",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fcvm.2026.1966647/full"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "issn:2297-055X",
      "subfield": "cardiovascular"
    }
  ],
  "title": "Development and internal validation of a 5-year major cardiovascular and cerebrovascular events prediction model using a simplified carotid plaque score in a hospital-based primary-prevention cohort",
  "title_text": "Development and internal validation of a 5-year major cardiovascular and cerebrovascular events prediction model using a simplified carotid plaque score in a hospital-based primary-prevention cohort",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:10Z",
  "url": "https://research.draconitic.com/paper/3eh1cdgw7w1rg",
  "venue": "Frontiers in Cardiovascular Medicine",
  "versions": []
}