J Korean Med Sci.  2016 Jun;31(6):902-908. 10.3346/jkms.2016.31.6.902.

Role of Coronary Artery Calcium Scoring in Detection of Coronary Artery Disease according to Framingham Risk Score in Populations with Low to Intermediate Risks

• Kim WJ
• Kwon CH
• Han S
• Lee WS
• Kang JW
• Ahn JM
• Lee JY
• Park DW
• Kang SJ
• Lee SW
• Kim YH
• Lee CW
• Park SW
• Park SJ

• KMID: 2373699
• DOI: http://doi.org/10.3346/jkms.2016.31.6.902

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.

Keyword

Coronary Artery Calcium Score; Coronary Computed Tomography; Coronary Computed Tomography Angiography; Framingham Risk Score

MeSH Terms

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
Calcium

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