Ability of HeartScore to identify coronary calcifications: Results from the DanRisk Study and the Heinz Nixdorf Recall study

Abstract

Purpose: The European HeartScore has traditionally differentiated between and risk Until 2012 Germany and Denmark were considered as high risk countries but has now been defined as low risk countries. In this survey we wanted to assess the consequences of this reclassification in identifying atherosclerosis in a healthy population from Germany (Heinz Nixdorf Recall Study) and Denmark (DanRisk Study). Methods: A screening of 4744 randomly selected (mean age 58, 45% male, 3581 from Heinz Nixdorf Recall Study, 1163 from the DanRisk Study) individuals free of cardiovascular disease was performed. Traditional risk factors were determined, and the HeartScore was measured for and risk A HeartScore ≥ 5% was considered as high-risk for cardiovascular mortality. A non-contrast Cardiac-CT scan was performed to detect coronary calcification, and atherosclerosis was defined as an Agatston score ≥ 10. Results: In a low risk country 19% of individuals had a HeartScore ≥ 5% vs. 35% in a high risk country. Atherosclerosis was detected in 44% of all individuals. Overall accuracy to detect atherosclerosis was 65% in a low risk country and 69% in a high risk country. Sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios are displayed in the table. View this table: Diagnostic accuracy of HeartScore to detect CAC-score ≥10 Conclusion: Since Germany and Denmark have been reclassified as low risk countries the diagnostic accuracy to detect coronary calcifications has slightly decreased, and the proportion of individuals with atherosclerosis despite a or intermediate HeartScore has increased.