Relationship Among Risk Score Systems and Coronary Atherosclerosis Determined by Multislice Computed Tomography.

Autor:	García-Lledó A; Department of Cardiology, University Hospital Principe de Asturias, and Department of Medicine, University of Alcalá, Alcalá de Henares, Spain. alberto.garcia-lledo@uah.es., Moya-Mur JL; Department of Cardiology University Hospital Ramón y Cajal, Madrid, Spain., Ponz-Mir V; Department of Cardiology, University Hospital Principe de Asturias, and Department of Medicine, University of Alcalá, Alcalá de Henares, Spain., Novo-Aparicio S; Department of Radiology University Hospital Príncipe de Asturias, Alcalá de Henares, Spain., Sanz-Barrio A; Department of Cardiology, University Hospital Principe de Asturias, and Department of Medicine, University of Alcalá, Alcalá de Henares, Spain., Álvarez-Sanz C; Department of Radiology University Hospital Príncipe de Asturias, Alcalá de Henares, Spain., de Santiago-Nocito A; GAI-Guadalajara, SESCAM, Guadalajara, Spain.
Jazyk:	angličtina
Zdroj:	Clinical cardiology [Clin Cardiol] 2016 Oct; Vol. 39 (10), pp. 603-607. Date of Electronic Publication: 2016 Sep 06.
DOI:	10.1002/clc.22573
Abstrakt:	Background: Risk score systems (RSS) were designed to estimate the risk of cardiac events. Their ability to predict coronary atherosclerosis (CA) has not been established. Hypothesis: Risk score systems can predict presence of CA in patients without typical symptoms or ischemia. Because design of each RSS is different, their predictive value could also differ. Methods: A retrospective analysis was done on patients from a low-risk region referred for cardiac multislice computed tomography (MSCT). The sample included low- to intermediate-risk patients with nontypical chest pain and asymptomatic high-risk patients. Patients with documented ischemia were excluded. Three RSS were determined: Framingham Risk Score (FRS), Regicor (FRS calibrated for Spanish population), and Systematic Coronary Risk Evaluation (SCORE). Coronary arteries were investigated to determine calcium score and presence of protruding atheromas. Results: We analyzed 582 patients (53.8% male; mean age 51 ± 11.5 years). Their mean estimated risk was intermediate: 15.6 ± 10.4 by FRS, 6.3 ± 4.3 by Regicor, and 3.9 ± 4.1 by SCORE. The MSCT showed no CA in 38.8%, nonobstructive plaques in 28.7%, and obstructive ones in 32.5%. The ability of the RSS to predict CA was not significantly different, with moderate diagnostic value (areas under ROC curves, 0.72-0.65). The prevalence of CA was high in low-risk patients: 40%, 47%, and 53% in FRS, Regicor, and SCORE low-risk patients, respectively. Conclusions: Risk score systems have only moderate diagnostic value to predict presence of CA, without significant differences among them. Coronary artery disease is highly prevalent in patients considered low risk. (© 2016 Wiley Periodicals, Inc.)
Databáze:	MEDLINE
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