Using clinical cardiovascular risk scores to predict coronary artery plaque severity and stenosis detected by CT coronary angiography in asymptomatic Chinese subjects
Journal
International Journal of Cardiovascular Imaging
Journal Volume
27
Journal Issue
5
Pages
669-678
Date Issued
2011
Author(s)
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 checkup 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 (C50% diameter stenosis), all risk scores had similar discrimination. In the prediction of severe CAD (C70% 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. ? 2011 Springer Science+Business Media, B.V.
SDGs
Other Subjects
adult; aged; angiocardiography; article; Chinese; computed tomographic angiography; contrast enhancement; controlled study; coronary artery atherosclerosis; coronary artery obstruction; diagnostic accuracy; diagnostic imaging; disease severity; female; Framingham risk score; human; intermethod comparison; major clinical study; male; risk assessment; scoring system; sensitivity and specificity; systematic coronary risk evaluation; Adult; Aged; Aged, 80 and over; Asian Continental Ancestry Group; Asymptomatic Diseases; Chi-Square Distribution; China; Coronary Angiography; Coronary Stenosis; Female; Humans; Male; Middle Aged; Plaque, Atherosclerotic; Predictive Value of Tests; Risk Assessment; Risk Factors; Severity of Illness Index; Taiwan; Tomography, X-Ray Computed; Young Adult
Type
journal article