Correlation between Risk Score Systems and the extent of Coronary Artery Disease detected by Multislice Computed Tomography

Abstract

Abstract Background Risk stratifying patients for cardiovascular diseases is crucial to formulate early effective prevention strategies. Risk scoring systems (RSS) as Framingham Risk Score (FRS) and the Systematic Coronary Risk Evaluation (SCORE) have been designed for early predictions of cardiovascular events in 10-year time. Objectives To study the correlation between Risk Score Systems and the extent of Coronary Artery Disease detected by Coronary CT angiography. Methods This analysis concluded 120 patients without known coronary disease referred to CCTA from January to June 2018. The extent of CAD, calcium score, coronary plaque burden, composition and distribution were assessed. The Framingham and SCORE risk scores were calculated, then correlation between them was done. Results This included 120 patients (mean age 54 + 9 years, 55% male patients). MSCT detected the presence of coronary lesions in 53.3% of the cases, 18.3% of them were with obstructive plaques (stenosis ≥ 50% in the LM or ≥ 70% in any other vessel). Both RSS had a good diagnostic value where SCORE was found to have a higher predictive value (area under ROC curves, 0.754 vs 0.711 for SCORE and FRS respectively). Low SCORE risk category showed the least number of patients with significant CAD (1/22 = 4.5%), compared to those with low risk using FRS (7/85 = 8.2%). High risk SCORE category included more patients with significant CAD (9/23 = 39%), compared to patients with FRS high risk category (3/10 = 30%). A high versus low risk SCORE was related to a higher plaque burden severity (mean burden 57.20=9.75 vs 50.17 + 9.75, respectively, P-value=0.008) and to a great incidence of Calcium Score (CS) > 100 (mean calcium 101.39 + 113.30 vs 3.18 + 13.40, respectively, P-value=0.000). A high versus low risk FRS was related to a higher plaque burden severity (mean burden 60.90 + 15.6 vs 54.06 + 8.04, respectively, P-value=0.039) and to a great incidence of Calcium Score (CS) > 100 (mean calcium 122.40 + 143.89 vs 26.84 + 81.75, respectively, P-value=0.001). Conclusion Risk score correlates well with the extent of CAD detected by MSCT where SCORE had a higher predictive value than FRS.