Predicted 10-year risk of cardiovascular disease among Canadian adults using modified Framingham Risk Score in association with dietary intake

2015 ◽  
Vol 40 (10) ◽  
pp. 1068-1074 ◽  
Author(s):  
Solmaz Setayeshgar ◽  
Susan J. Whiting ◽  
Punam Pahwa ◽  
Hassanali Vatanparast
Keyword(s):  
Cardiovascular Disease ◽  
High Risk ◽  
Dietary Intake ◽  
Risk Score ◽  
Framingham Risk Score ◽  
Traditional Approach ◽  
Fruit And Vegetable ◽  
Breakfast Cereal ◽  
Framingham Risk ◽  
Significant Difference

Initial risk assessment to estimate 10-year risk of cardiovascular disease (CVD) is completed by Framingham Risk Score (FRS). In 2012 2 modifications were added to FRS by the Canadian Cardiovascular Society: FRS is doubled in subjects aged 30–59 years who have CVD present in a first-degree relative before 55 years of age for men and 65 years of age for women; and cardiovascular age is calculated for each individual. Our aim was to implement these modifications and evaluate differences compared with traditional FRS. Further, we evaluated the association between dietary intake and 10-year risk. The Canadian Health Measures Survey data cycle 1 was used among participants aged 30–74 years (n = 2730). Descriptive and logistic regression analyses were conducted using STATA SE 11. Using modified FRS for predicting 10-year risk of CVD significantly increased the estimated risk compared with the traditional approach, 8.66% ± 0.35% versus 6.06% ± 0.18%, respectively. Greater impact was observed with the “cardiovascular age” modification in men versus women. The distribution of Canadians in low- (<10%) and high-risk (≥20%) categories of CVD show a significant difference between modified and traditional FRS: 67.4% versus 79.6% (low risk) and 13.7% versus 4.5% (high risk), respectively. The odds of having risk ≥10% was significantly greater in low-educated, abdominally obese individuals or those with lower consumption of breakfast cereal and fruit and vegetable and greater potato and potato products consumption. In conclusion, the traditional FRS method significantly underestimates CVD risk in Canadians; thus, applying modified FRS is beneficial for screening. Additionally, fibre consumption from fruit and vegetable or breakfast cereals might be beneficial in reducing CVD risks.

scholarly journals Prediksi Tingkat Risiko Penyakit Kardiovaskuler Aterosklerotik pada Pasien yang Berobat di Poliklinik Penyakit Dalam RSUP Prof. Dr. R. D. Kandou Manado

e-CliniC ◽  
2017 ◽  
Vol 5 (2) ◽  
Author(s):  
Engelin E. Emor ◽  
Agnes L. Panda ◽  
Janry Pangemanan
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
High Risk ◽  
Risk Score ◽  
Framingham Risk Score ◽  
Low Risk ◽  
Risk Level ◽  
Atherosclerotic Cardiovascular Disease ◽  
Cross Sectional ◽  
Framingham Risk

Abstract: Atherosclerotic cardiovascular disease is caused by the accumulation of plaque on the artery wall causing dysfunction of anatomical and hemodynamic system of the heart and blood flow. There are many risk factors that cause atherosclerotic cardiovascular disease which are divided into modifiable and unmodifiable risk factors. Prevention of this disease can be achieved with early detection, such as prediction the risk level of 10 years ahead of atherosclerotic cardiovascular disease by using the Framingham Risk Score (FRS). This study was aimed to obtain the risk level of atherosclerotic cardiovascular disease in patients at Internal Medicine Polyclinic of Prof. Dr. R. D. Kandou Hospital Manado by using their medical records from September to October 2017. This was a descriptive study with a cross sectional design. There were 100 samples obtained by using conclusive sampling technique. Of the 100 patients, 42 (42%) patients had low risk, 27 (27%) patients had moderate risk, and 31 (31%) patients had high risk of atherosclerotic cardiovascular disease in 10 years ahead. Conclusion: In this study, the highest percentage was in patients with low risk, followed by patients with high risk, and moderate risk.Keywords: ASCVD, Framingham Risk Score, Risk of atherosclerotic cardiovascular sisease. Abstrak: Penyakit kardiovaskuler aterosklerotik adalah penyakit yang disebabkan oleh adanya timbunan plak pada dinding arteri sehingga menyebabkan gangguan fungsional, anatomis serta sistem hemodinamis jantung dan pembuluh darah. Terdapat banyak faktor risiko yang menyebabkan terjadinya penyakit kardiovaskuler aterosklerotik yang dibagi menjadi faktor risiko yang dapat dimodifikasi dan yang tidak dapat dimodifikasi. Pencegahan penyakit ini dapat dilakukan dengan deteksi dini, salah satunya yaitu dengan memrediksi tingkat risiko 10 tahun kedepan terjadinya penyakit kardiovaskuler aterosklerotik dengan menggunakan Framingham Risk Score. Penelitian ini bertujuan untuk mengetahui tingkat risiko penyakit kardiovaskuler ateroskerotik pada pasien di Poliklinik Penyakit Dalam RSUP Prof. Dr. R. D. Kandou Manado. Jenis penelitian ialah deskriptif dengan desain potong lintang menggunakan data rekam medik pasien Poliklinik Penyakit Dalam RSUP Prof. Dr. R. D. Kandou Manado periode September - Oktober 2017. Sampel penelitian berjumlah 100 orang dengan teknik pengambilan conclusive sampling. Terdapat 42 pasien (42%) dengan tingkat risiko rendah, 27 pasien (27%) dengan risiko sedang, dan 31 pasien (31%) dengan risiko tinggi terkena penyakit kardiovaskuler aterosklerotik 10 tahun kedepan. Simpulan: Pada studi ini, persentase tertinggi ialah pasien dengan tingkat risiko rendah terjadinya penyakit kardiovaskuler aterosklerotik, diikuti tingkat risiko tinggi dan risiko sedang.Kata kunci: ASCVD, Framingham Risk Score, tingkat risiko penyakit kardiovaskuler aterosklerotik

scholarly journals Estimation of the 10-Year Atherosclerotic Cardiovascular Disease and The Framingham Risk Score Among Adults Living with HIV/AIDS in Addis Ababa, Ethiopia: A Hospital-Based, Observational Study.

2021 ◽  
Author(s):  
Minyahil Woldu ◽  
Omary Minzi ◽  
Workineh Shibeshi ◽  
Aster Shewaamare ◽  
Ephrem Engidawork
Keyword(s):  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
High Risk ◽  
Risk Score ◽  
Significant Contribution ◽  
Framingham Risk Score ◽  
Atherosclerotic Cardiovascular Disease ◽  
Framingham Risk ◽  
Living With Hiv

Abstract Background With a much improved ART of the present day, most morbidities and mortalities in people living with HIV/AIDS (PLWHA) are associated with factors such as non-infectious diseases (NIDs) in the form of coronary heart disease (CHD). This study aimed at determining the prevalence and predictors of coronary heart disease (CHD) using the 10-year atherosclerotic cardiovascular disease (ASCVD) and Framingham risk score (FRS) tools among PLWHA. Methods A hospital-based, observational study was carried out from January 2019 to February 2020 in HIV infected adults. Prevalence of FRS (age 20 to 79) was determined using the National, Heart, Lung and Blood Institute (NHLBI) and prevalence of ASCVD (age 40 to 79) was determined using the peer-reviewed online (ClinCalc.com) tool. Results Using the 10-years ASCVD risk estimation 27.3% of the study participants had an elevated risk > 7.5 % CHD. Similarly using the 10-year FRS, 1.4 % had high-risk score of developing CHD. Using multiple linear regression analysis age (β = .061, p < .001), gender (β = .816, p < .001), systolic blood pressure (β = .21, p < .001), total cholestrol (β = .002, p = .001), high density lipoprotein (β = − .02, p < .001), and Tobacco use (β = .559, p < .001) had significant contribution to the risk of CHD using the ASCVD tool, while using binary logistic regression for the FRS tool, gender (OR = 26.105, 95% C.I. [6.110, 111,543], p < 0.001), age (OR = 1.293, 95% C.I. [1.181, 1.415], P < 0.001), and low HDL-C (OR = 0.887, 95% C.I. [.786, .979], P = 0.19) had significant contribution. Conclusions The prevalence of high-risk CHD among PLWHA using the FRS and ASCVD tools were 1.4 & 27.3 percent respectively. In both the tools advanced age, male gender, and low level HDL were significant contributor for the risk of CHD in PLWHA.

scholarly journals Assessment of cardiovascular risk tools as predictors of cardiovascular disease events in systemic lupus erythematosus

2021 ◽  
Vol 8 (1) ◽  
pp. e000448
Author(s):  
Jagan Sivakumaran ◽  
Paula Harvey ◽  
Ahmed Omar ◽  
Oshrat Tayer-Shifman ◽  
Murray B Urowitz ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
High Risk ◽  
Negative Predictive Value ◽  
Risk Score ◽  
Predictive Value ◽  
Framingham Risk Score ◽  
Cvd Risk ◽  
Framingham Risk ◽  
Number Of Patients

BackgroundSLE is an independent risk factor for cardiovascular disease (CVD). This study aimed to determine which among QRISK2, QRISK3, Framingham Risk Score (FRS), modified Framingham Risk Score (mFRS) and SLE Cardiovascular Risk Equation (SLECRE) best predicts CVD.MethodsThis is a single-centre analysis on 1887 patients with SLE followed prospectively according to a standard protocol. Tools’ scores were evaluated against CVD development at/within 10 years for patients with CVD and without CVD. For patients with CVD, the index date for risk score calculation was chosen as close to 10 years prior to CVD event. For patients without CVD, risk scores were calculated as close to 10 years prior to the most recent clinic appointment. Proportions of low-risk (<10%), intermediate-risk (10%–20%) and high-risk (>20%) patients for developing CVD according to each tool were determined, allowing sensitivity, specificity, positive/negative predictive value and concordance (c) statistics analysis.ResultsAmong 1887 patients, 232 CVD events occurred. QRISK2 and FRS, and QRISK3 and mFRS, performed similarly. SLECRE classified the highest number of patients as intermediate and high risk. Sensitivities and specificities were 19% and 93% for QRISK2, 22% and 93% for FRS, 46% and 83% for mFRS, 47% and 78% for QRISK3, and 61% and 64% for SLECRE. Tools were similar in negative predictive value, ranging from 89% (QRISK2) to 92% (SLECRE). FRS and mFRS had the greatest c-statistics (0.73), while QRISK3 and SLECRE had the lowest (0. 67).ConclusionmFRS was superior to FRS and was not outperformed by the QRISK tools. SLECRE had the highest sensitivity but the lowest specificity. mFRS is an SLE-adjusted practical tool with a simple, intuitive scoring system reasonably appropriate for ambulatory settings, with more research needed to develop more accurate CVD risk prediction tools in this population.

scholarly journals Differences of Cardiovascular Risk-based on Atherogenic Index Plasma Dan Framingham Risk Score in Postpartum with Preeclampsia and Normotensive

2020 ◽  
Vol 8 (B) ◽  
pp. 389-394
Author(s):  
Cinthya Ayu Meritha Siregar ◽  
Makmur Sitepu ◽  
M. Rhiza Z Tala ◽  
Johny Marpaung ◽  
Henry Salim Siregar ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Diastolic Blood Pressure ◽  
Risk Score ◽  
Framingham Risk Score ◽  
Atherogenic Index ◽  
Control Group ◽  
Framingham Risk ◽  
Significant Difference

BACKGROUND: Cardiovascular disease is the number one cause of death in women worldwide. Preeclampsia may be more than just risk factor for the development of cardiovascular disease later in life. Systematic reviews suggested approximately double the risk of ischemic heart disease, cerebrovascular incidents, and mortality of cardiovascular disease after preeclampsia. AIM: The aim of the study was to analyze the differences of cardiovascular risk later in life-based on atherogenic index plasma and Framingham risk score (FRS) in postpartum women with preeclampsia compared with normotensive women. METHODS: This is study a comparative analytic study with case–control design on 46 subjects, divided by 23 postpartum preeclampsia patients as a case sample subject and 23 postpartum with no history of hypertension as the control group. Subjects were examined for blood pressure, height, weight, and asked to fast for at least 8 h before blood lipid profile and glucose were examined with laboratory methods. Atherogenic index plasma and FRS were measured. Data were analyzed using SPSS version 25. p < 0.05 was considered significant. RESULTS: Based on the results, the study found significant differences between systolic and diastolic blood pressure in preeclampsia compared to the control group. Median systolic and diastolic blood pressure in the preeclampsia group compared to control group were 180 versus 110 in systolic blood pressure; 100 versus 80 in diastolic blood pressure with p < 0.000. Total cholesterol, low-density lipid, high-density lipoprotein, and triglycerides levels in preeclampsia were 218.38 ± 23.26 mg/dL, 128.60 ± 22.74 mg/dL, 38.60 ± 5.99 mg/dL, and 252.73 ± 47.16 mg/dL, respectively, with p < 0.05 and non-preeclampsia group were 143.0 ± 16.82 mg/dL, 69.17 ± 23.03 mg/dL, 51.73 ± 8.65 mg/dL, and 121.30 ± 14.65 mg/dL, respectively, with p < 0.05. Differences in plasma atherogenic index values can clearly be observed in the preeclampsia and control groups (p < 0.05). A similar interpretation was found in the FRS (p < 0.05). There was a significant positive correlation between age and body mass index with atherogenic index plasma and FRS in preeclamptic group. CONCLUSION: There was a significant difference in atherogenic index plasma and Framingham risk score of postpartum preeclampsia and normotensive women.

scholarly journals Framingham Risk Score for Cardiovascular Disease: Application to Jordanian Community; A cross sectional study

2021 ◽  
Author(s):  
shereen Arabiyat ◽  
odate tadros ◽  
Tamara Al-daghastani ◽  
Deema Jaber
Keyword(s):  
Cardiovascular Disease ◽  
Heart Disease ◽  
Risk Score ◽  
Cardiac Event ◽  
Framingham Risk Score ◽  
Lipid Lowering ◽  
Framingham Score ◽  
Event Risk ◽  
Framingham Risk ◽  
Significant Difference

Objective: The aim of this study is to assess the protective measures taken by the Jordanian population in order to decrease the risk of the first cardiovascular event using Framingham score risk classification to assess cardiac event risk. Methods: Several nationally representative models of adult Jordanians were recruited in this study. Demographic data and anthropometric parameters were documented. Framingham risk score was calculated. Accordingly, cardiac event risk has been determined. Google form was created to generate a survey. Social media was utilized to extend the survey. Key findings: As expected, taking lipid lowering medications has decreased the Framingham score significantly, patients with high HDL value have lower Framingham score. Significant difference in Framingham score between diploma and patients with high school or less education level p-value 0.043. There was a significant difference in Framingham score between nonsmokers and sometimes smokers. The study revealed that 90% of the participants were having low risk for developing CVD, 5% were at intermediate risk and 5% were at high risk for developing CVD. This was expected as the average age was between 20-30 years. Conclusion: This study presented no advantage and even some harm because of consuming daily low-dose aspirin in some groups of people formerly thought to benefit from such treatment. This new piece of information applies to patients who do not have identified cardiovascular disease. If you have not had one of the above situations or events and are older than 70 years, younger than 40 years, or at higher danger of bleeding because of a medical condition or treatments, you should not consume aspirin for principal prevention of heart disease. If you are between 40 and 70 years old, at decreased risk of bleeding, and thought to be at increased risk of heart disease, you might get advantage from using aspirin.

scholarly journals The Ten-Year Risk of Developing Cardiovascular Disease Among Public Health Workers In North-Central Nigeria Using Framingham And Atherogenic Index of Plasma Risk Scores

2021 ◽  
Author(s):  
Olubunmi Abiola Olubiyi ◽  
Bosede Folashade Rotimi ◽  
Munirat Ayoola Afolayan ◽  
Bilqis Wuraola Alatishe-Muhammed ◽  
Olufemi Mubo Olubiyi ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
High Risk ◽  
Risk Score ◽  
Framingham Risk Score ◽  
Health Workers ◽  
Atherogenic Index ◽  
Cvd Risk ◽  
North Central ◽  
Atherogenic Index Of Plasma ◽  
Framingham Risk

Abstract Background: Estimation of total cardiovascular disease (CVD) risk with the use of risk prediction charts such as the Framingham risk score and Atherogenic index of plasma score is a huge improvement on the practice of identifying and treating each of the risk factors such as high blood pressure and elevated blood cholesterol. The estimation of the total risk highlights that CVD risk factors occur together and thereby predicts who should be treated. There is scarcity of data on the risk scoring of adults in Nigeria including health workers. Therefore, this study was done to estimate the cardiovascular risks of health workers in public health services in north-central NigeriaMethods: A cross-sectional survey was performed using validated Framingham risk score calculator and calculation of risk based on the lipid profile of 301 randomly selected health workers in North-central Nigeria. Descriptive analysis was done using frequency counts and percentages while inferential statistics were done using chi square and correlation analyses using statistical Package for Social Sciences (SPSS) version 21.0. The confidence level was 95% and the level of significance was set at 0.05.Results: The 10-year risk of developing CVD was generally low in the health workers. Using Framingham risk score, 98.3% of health workers have low risk, 1.0% have moderate risk and 0.7% have high risk. Among the cadres of health workers, 1.5% of the nurses have moderate risk while 2.5% of the doctors and 3.3% of the CHEWs have high risk of developing CVD in 10 years. Using Atherogenic index of plasma scoring, only 2% of the health workers have high risk, 4.7% have intermediate risk while 93.4% have low risk. Across the cadres, 6.3% of the nurses and 3.3% of the CHEWs have intermediate risk while 2.4% of the nurses and 3.3% of the CHEWs have high risk. These findings were however not statistically significant.Conclusions: the 10-year risk of developing cardiovascular disease was low in the health workers in this study using both Framingham’s risk score and atherogenic index of plasma scores

scholarly journals Serum microRNA-204 Levels are Associated with Long-Term Cardiovascular Diseases Risk Using Framingham Risk Score in Patients with Type 2 Diabetes: Results From an Observational Study

2020 ◽  
Author(s):  
Rui Wang ◽  
Yaodong Ding ◽  
Yuqiang Pei ◽  
Yingxin Zhao ◽  
Xiaoli Liu ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
High Risk ◽  
Risk Score ◽  
Protective Factor ◽  
Framingham Risk Score ◽  
Risk Group ◽  
Circulating Mirna ◽  
Framingham Risk

Abstract Background: The basic studies have demonstrated that microRNA-204 (miRNA-204) was involved in the process of atherosclerosis and vascular calcification. However, the value of miRNA-204 as a predictive biomarker for cardiovascular disease (CVD) is still controversial. The purpose of the present study was to evaluate the association between circulating miRNA-204 level and the 10-year cardiovascular disease risk score, Framingham risk score (FRS).Method: The subjects consecutively enrolled 194 patients with type 2 diabetes mellitus without cardiovascular disease at Anzhen Hospital from January 2015 to September 2016. We used the Framingham Risk Score (FRS) to evaluate the risk of cardiovascular disease. Circulating miRNA-204 levels were measured by quantitative Real-Time polymerase chain reaction (qRT-PCR).Result: The circulating miRNA-204 levels were significantly lower in high risk group of CVD (FRS > 20%) of patients (0.49 ± 0.13) compared with that in low risk group (FRS < 10%) and intermediate risk group (FRS = 10%-20%) (0.87 ± 0.19, 0.75 ± 0.25, Respectively, p < 0.001). FRS was negatively correlated with miR-204 levels (r=-0.421, p < 0.001). According to multivariate logistic analyses, miRNA-204 levels were still significantly and independently associated with the high risk of CVD after adjusting the conventional risk factor. Receiver-operating characteristic curve (ROC) analysis also showed that circulating miRNA-204 level can predict the high risk of CVD, and the specificity was higher than traditional risk factors SBP and protective factor HDL-C of CVD.Conclusion: Our study demonstrated that patients with lower circulating miRNA-204 levels were at a high risk for the progression of CVD. After adjustment for potential confounders, miRNA-204 was independently associated with CVD in patients with T2DM.

scholarly journals Cardiovascular disease risk assessment among patients attending two cardiac clinics in the Ashanti Region of Ghana

2020 ◽  
Vol 54 (3) ◽  
pp. 140-145
Author(s):  
Waindim Nyiambam ◽  
Augustina Sylverken ◽  
Isaac Owusu ◽  
Kwame Buabeng ◽  
Fred Boateng ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Risk Assessment ◽  
High Risk ◽  
Risk Score ◽  
Framingham Risk Score ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Risk Scores ◽  
Ashanti Region ◽  
Framingham Risk

Background: Cardiovascular disease (CVD) is a major cause of morbidity and hypertension is the single most important modifiable risk. Assessment of an individual’s “total” predicted risk of developing a CVD event in 5- or 10-years using risk scores has been identified as an accurate measure of CVD risk. Using the latest Framingham risk score we assessed the risk among patients attending two cardiac clinics in Kumasi.Methods: We conducted a hospital-based cross-sectional study among 441 patients attending two cardiac clinics in Kumasi, the Ashanti region of Ghana. Hospital records were reviewed and information on demography, social history and laboratory results for the lipid profile tests were extracted.Results: The prevalence of low, medium and high risk were 41.5%, 28.1% and 30.4% respectively. More men were at high risk compared to females (36.0% vs 23.9%, p=0.003). The risk score showed good discrimination for cardiovascular risk stratification with an overall area under the curve of 0.95; 0.97 and 0.94 for males and females respectively. The sensitivity and specificity of the Framingham risk score were 89.5% and 86.3%, respectively.Conclusion: Majority of our study participants were at moderate to high risk with men being the most affected. The Framingham risk score proved to be a useful tool in predicting the 10-year total cardiovascular disease risk.Keywords: cardiovascular diseases, hypertension, Kumasi, total risk, Framingham risk scoreFunding: Not indicated

scholarly journals Cardiovascular Risk Estimation in Patients with Hypertension: A Cross- Sectional Study

Jurnal NERS ◽  
2020 ◽  
Vol 15 (1) ◽  
pp. 98
Author(s):  
Nina Calisanie ◽  
Santi Susanti ◽  
Linlin Lindayani
Keyword(s):  
Cardiovascular Disease ◽  
High Risk ◽  
Risk Score ◽  
Framingham Risk Score ◽  
Risk Estimation ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Retrieval Technique ◽  
Framingham Risk ◽  
Cross Sectional Design

Introduction: Cardiovascular disease is a disease caused by the misfunctioning of the heart and blood vessels. Atherosclerosis is the main cause of cardiovascular disease. Prevention and control of cardiovascular disease can be done with early detection through screening activities. Framingham Risk Score using Body Mass Index (FRS BMI) risk assessment is very useful and easy, which is used without using lipid indicator. This study aims to estimate the risk of cardiovascular disease on patients with hypertension with Framingham Risk Score BMI.Methods: The study used a descriptive method with cross-sectional design. The samples in this study were 130 respondents who were selected using consecutive sampling and retrieval technique by using FRS BMI application questionnaire.Results: There were 11.5% respondents in low risk of CVD, 22.7% respondents at moderate risk and 60.8% respondents in higher category of cardiovascular disease 10 years later.Conclusion: Majority of patients with hypertension showed a high risk of CVD for the next 10 years. Patients’ sex and age also play an important role to increase the risk, whereby men show a higher risk of CVD for the next ten years. The hospital management and health worker should pay more attention and educate the patient about the prevention of heart disease for the next 10 years, especially for those with high risk of CVD based on FRS BMI measurement.

The utility of coronary artery calcium in non-gated high resolution CT thorax scans in predicting cardiac events as compared to the Framingham risk score: a retrospective study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
S Saluja ◽  
H Contractor ◽  
M Daniells ◽  
J Sobolewska ◽  
K Khan ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Retrospective Study ◽  
Coronary Artery ◽  
Risk Score ◽  
Framingham Risk Score ◽  
Cardiac Events ◽  
End Point ◽  
Framingham Risk ◽  
Good Concordance

Abstract Background There is existing evidence to suggest a correlation between coronary artery calcification (CAC) measured using ECG-triggered chest computed tomography and cardiovascular disease. Further evidence has emerged to suggest a correlation between CAC measured using non-gated CT scans and cardiovascular disease. Herein, we sought to ascertain the utility of incidental findings of CAC on non-triggered high resolution CT (HRCT) thorax used for patients undergoing lung cancer screening or follow-up for interstitial lung disease and Framingham risk score (FRS) in predicting cardiovascular events. Methods The Computerised Radiology Information Service (CRIS) database was manually searched to determine all HRCT scans performed in a single trust from 05/2015 to 05/2016. The reports issued by Radiologists and images of selected studies were reviewed. For patients with CAC, we calculated the calcium score for patients using the Agatston method. Clinical events were determined from the electronic medical record without knowledge of patients' CAC findings. For these patients, the Framingham Risk Score (FRS) was also calculated. The primary end point of the study was composite of all-cause mortality and cardiac events (non-fatal myocardial infarction, coronary revascularization, new atrial fibrillation or heart failure episode requiring hospitalization). Results We selected 300 scans from a total of approximately 2000 scans performed over this time. Data at follow up was available for 100% of the patients, with a median duration of follow up of 1.6 years. Moderate to severe CAC was found in 35% of people. Multivariable analysis showed good concordance between CAC and FRS in predicting composite clinical end point. The Odds Ratio for cardiac events in patients with moderate to severe CAC was 5.3 (p&lt;0.01) and for composite clinical end point was 3.4 (p&lt;0.01). This is similar to the OR predicted by the FRS: 4.8; p&lt;0.01 and 3.1; p&lt;0.01 respectively. Only 6.2% of patients with moderate to severe CAC were currently statin treated. Conclusion In this retrospective study of patients with respiratory disease attending for HRCT scanning, co-incidentally detected CAC predicts cardiac events, with good concordance with the FRS. The incidental finding of CAC on non-gated CT scanning should be reported with Agatston score calculation allowing consideration of intervention to mitigate cardiovascular risk and optimize. Further multi-centre prospective studies of this strategy, with a larger patient cohort should be conducted to clarify the utility of CAC as a prediction tool to modify cardiac risk. Funding Acknowledgement Type of funding source: None

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