Published in:
01-06-2011 | Original paper
Using clinical cardiovascular risk scores to predict coronary artery plaque severity and stenosis detected by CT coronary angiography in asymptomatic Chinese subjects
Authors:
Bai-Chin Lee, Wen-Jeng Lee, Hsiu-Ching Hsu, Kuo-Liong Chien, Tiffany Ting-Fang Shih, Ming-Fong Chen
Published in:
The International Journal of Cardiovascular Imaging
|
Issue 5/2011
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Abstract
We aimed to determine whether the Framingham risk score (FRS), systematic coronary risk evaluation (SCORE), and Chinese multi-provincial cohort study (CMCS) could predict anatomic severity of coronary plaques. From January 2007 to October 2010, we performed a contrast-enhanced 64-slice or 256-slice multidetector computed tomography coronary angiography as part of a health check-up protocol in 806 asymptomatic subjects (70.5% male, 56 ± 9 year-old). Risk scores significantly correlated with calcium volume score, plaque stenosis score and plaque distribution score (P < 0.001). Of the 3 risk scores, the SCORE system showed the best correlation. Overall, 180 (22%) and 37 (5%) subjects were found to have stenosis of 50-69% and more than 70% in at-least one coronary artery segment, respectively. In the prediction of the presence of obstructive CAD (≥50% diameter stenosis), all risk scores had similar discrimination. In the prediction of severe CAD (≥70% diameter stenosis), FRS and CMCS had similar area under curves but SCORE discriminated better than FRS (P < 0.05). The optimal cutoff point to predict obstructive CAD was 9.54% for FRS, 1.05% for CMCS, and 0.95% for SCORE, whereas to predict severe CAD was 9.63, 1.05, 1.15% for FRS, CMCS, SCORE, respectively, with a sensitivity of 0.61–0.70 and a specificity of 0.55–0.66. Cardiovascular risk scores are associated with the severity and extent of coronary artery plaque. The stronger association might translate into a better discrimination using SCORE. These findings will aid in the appropriate selection or recalibration of the risk assessment system for cardiovascular disease screening.