Role of Coronary Artery Calcium Scoring in Detection of Coronary Artery Disease according to Framingham Risk Score in Populations with Low to Intermediate Risks
- Authors
- Kim, Won-Jang; Kwon, Chang Hee; Han, Seungbong; Lee, Woo Seok; Kang, Joon Won; Ahn, Jung-Min; Lee, Jong-Young; Park, Duk-Woo; Kang, Soo-Jin; Lee, Seung-Whan; Kim, Young-Hak; Lee, Cheol Whan; Park, Seong-Wook; Park, Seung-Jung
- Issue Date
- Jun-2016
- Publisher
- KOREAN ACAD MEDICAL SCIENCES
- Keywords
- Coronary Artery Calcium Score; Coronary Computed Tomography; Coronary Computed Tomography Angiography; Framingham Risk Score
- Citation
- JOURNAL OF KOREAN MEDICAL SCIENCE, v.31, no.6, pp.902 - +
- Journal Title
- JOURNAL OF KOREAN MEDICAL SCIENCE
- Volume
- 31
- Number
- 6
- Start Page
- 902
- End Page
- +
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/8244
- DOI
- 10.3346/jkms.2016.31.6.902
- ISSN
- 1011-8934
- 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.
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