Abstract 9982: World Health Organization Cardiovascular Risk Score Correlates with Carotid Intima-Media Thickness, but Fails to Identify High Risk Black Patients Unlike the Framingham and Atherosclerotic Cardiovascular Risk Score Models

Abstract

Introduction: Correlation between various cardiovascular risk models and carotid intima-media thickness (CIMT) in the black population is not well described. To risk stratify patients in Ethiopia, three scores are used: Non-laboratory World Health Organization (nWHO) score, used for Sub-Saharan countries, ACC/AHA atherosclerotic cardiovascular risk score (ASCVD), and Framingham risk score (FRS). We compared these three scores and determined their relationship with a marker of subclinical atherosclerosis such as CIMT. Methodology: 336 patients (ages 40-79) with no atherosclerotic cardiovascular disease were randomly selected in Ethiopia’s largest tertiary hospital and underwent CIMT measurement read by blinded readers. Participants were stratified into low, intermediate, and high-risk groups based on the three scores. Pearson correlations and Freedman’s comparisons were used. Results: The three risk scores and mean CIMT were moderately correlated (Figure 1). There were strong positive correlations between ASCVD and FRS (n=284, r=0.71, CI: 0.65-0.77, p<.0001), ASCVD and nWHO (n=279, r =0.73, CI: 0.67-0.78, p<.0001), as well as FRS and nWHO risk scores (n=331, r=0.76, CI: 0.71-0.78, p<.0001). However, there was significant disagreement in their risk categorization (Figure 2). Conclusion: Non-laboratory WHO risk score fails to identify high-risk patients stratified by ASCVD or FRS despite having similar correlations with CIMT. The use of nWHO score may underestimate risk in the Ethiopian population, compared to ASCVD and FRS scores. These findings have therapeutic implications for primary prevention.