Role of Coronary Artery Calcium Scoring in Detection of Coronary Artery Disease according to Framingham Risk Score in Populations with Low to Intermediate Risks.
10.3346/jkms.2016.31.6.902
- Author:
Won Jang KIM
1
;
Chang Hee KWON
;
Seungbong HAN
;
Woo Seok LEE
;
Joon Won KANG
;
Jung Min AHN
;
Jong Young LEE
;
Duk Woo PARK
;
Soo Jin KANG
;
Seung Whan LEE
;
Young Hak KIM
;
Cheol Whan LEE
;
Seong Wook PARK
;
Seung Jung PARK
Author Information
1. Department of Cardiology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea.
- Publication Type:Original Article
- Keywords:
Coronary Artery Calcium Score;
Coronary Computed Tomography;
Coronary Computed Tomography Angiography;
Framingham Risk Score
- MeSH:
Aged;
Calcium/*analysis;
Coronary Artery Disease/*diagnosis/epidemiology/pathology;
Coronary Vessels/*chemistry/diagnostic imaging/metabolism;
Female;
Humans;
Logistic Models;
Male;
Middle Aged;
Multivariate Analysis;
Prevalence;
Risk Factors;
Severity of Illness Index;
Tomography, X-Ray Computed
- From:Journal of Korean Medical Science
2016;31(6):902-908
- CountryRepublic of Korea
- Language:English
-
Abstract:
Current guidelines recommend that coronary artery calcium (CAC) screening should only be used for intermediate risk groups (Framingham risk score [FRS] of 10%-20%). The CAC distributions and coronary artery disease (CAD) prevalence in various FRS strata were determined. The benefit to lower risk populations of CAC score-based screening was also assessed. In total, 1,854 participants (aged 40-79 years) without history of CAD, stroke, or diabetes were enrolled. CAC scores of > 0, ≥ 100, and ≥ 300 were present in 33.8%, 8.2%, and 2.9% of the participants, respectively. The CAC scores rose significantly as the FRS grew more severe (P < 0.01). The total CAD prevalence was 6.1%. The occult CAD prevalence in the FRS ≤ 5%, 6%-10%, 11%-20%, and > 20% strata were 3.4%, 6.7%, 9.0%, and 11.6% (P < 0.001). In multivariate logistic regression analysis adjusting, not only the intermediate and high risk groups but also the low risk (FRS 6%-10%) group had significantly increased odds ratio for occult CAD compared to the very low-risk (FRS ≤ 5%) group (1.89 [95% confidence interval, CI, 1.09-3.29] in FRS 6%-10%; 2.48 [95% CI, 1.47-4.20] in FRS 11%-20%; and 3.10 [95% CI, 1.75-5.47] in FRS > 20%; P < 0.05). In conclusion, the yield of screening for significant CAC and occult CAD is low in the very low risk population but it rises in low and intermediate risk populations.
