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KMID : 0191120160310060902
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Journal of Korean Medical Science
2016 Volume.31 No. 6 p.902 ~ p.908
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Role of Coronary Artery Calcium Scoring in Detection of Coronary Artery Disease according to Framingham Risk Score in Populations with Low to Intermediate Risks
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Kim Won-Jang
Kwon Chang-Hee
Han Seung-Bong
Lee Woo-Seok
Kang Joon-Won
Ahn Jung-Min
Lee Jong-Young
Park Duk-Woo
Kang Soo-Jin
Lee Seung-Whan
Kim Young-Hak
Park Seong-Wook
Park Seung-Jung
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Abstract
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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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KEYWORD
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Coronary Artery Calcium Score, Coronary Computed Tomography, Coronary Computed Tomography Angiography, Framingham Risk Score
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