title: Role of Coronary Artery Calcium Scoring in Detection of Coronary Artery Disease according to Framingham Risk Score in Populations with Low to Intermediate Risks.
abstract: 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.
authors.affiliation: Department of Cardiology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea .
authors.forename: Won-Jang
authors.identifier: 0000-0002-9915-3722
authors.initials: WJ
authors.lastname: Kim
authors.affiliation: Department of Cardiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea .
authors.forename: Chang Hee
authors.identifier: 0000-0001-8716-1146
authors.initials: CH
authors.lastname: Kwon
authors.affiliation: Department of Applied Statistics, Gachon University, Seongnam, Korea .
authors.forename: Seungbong
authors.identifier: 0000-0003-2938-8072
authors.initials: S
authors.lastname: Han
authors.affiliation: Department of Cardiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea .
authors.forename: Woo Seok
authors.identifier: 0000-0003-0250-1266
authors.initials: WS
authors.lastname: Lee
authors.affiliation: Department of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea .
authors.forename: Joon Won
authors.identifier: 0000-0001-5756-3814
authors.initials: JW
authors.lastname: Kang
authors.affiliation: Department of Cardiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea .
authors.forename: Jung-Min
authors.identifier: 0000-0003-4031-391X
authors.initials: JM
authors.lastname: Ahn
authors.affiliation: Department of Cardiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea .
authors.forename: Jong-Young
authors.identifier: 0000-0002-0092-9958
authors.initials: JY
authors.lastname: Lee
authors.affiliation: Department of Cardiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea .
authors.forename: Duk-Woo
authors.identifier: 0000-0001-6643-0239
authors.initials: DW
authors.lastname: Park
authors.affiliation: Department of Cardiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea .
authors.forename: Soo-Jin
authors.identifier: 0000-0003-1115-6097
authors.initials: SJ
authors.lastname: Kang
authors.affiliation: Department of Cardiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea .
authors.forename: Seung-Whan
authors.identifier: 0000-0002-9301-8183
authors.initials: SW
authors.lastname: Lee
authors.affiliation: Department of Cardiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea .
authors.forename: Young-Hak
authors.identifier: 0000-0002-5956-1254
authors.initials: YH
authors.lastname: Kim
authors.affiliation: Department of Cardiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea .
authors.forename: Cheol Whan
authors.identifier: 0000-0002-9185-6669
authors.initials: CW
authors.lastname: Lee
authors.affiliation: Department of Cardiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea .
authors.forename: Seong-Wook
authors.identifier: 0000-0001-7371-4336
authors.initials: SW
authors.lastname: Park
authors.affiliation: Department of Cardiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea .
authors.forename: Seung-Jung
authors.identifier: 0000-0002-9187-5405
authors.initials: SJ
authors.lastname: Park
mesh_terms: D000368:Aged; D002118:Calcium / Q000032:analysis*; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D003331:Coronary Vessels / Q000737:chemistry* / Q000000981:diagnostic imaging / Q000378:metabolism; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D012307:Risk Factors; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed
chemical_list: D002118:Calcium
keywords: Coronary Artery Calcium Score; Coronary Computed Tomography; Coronary Computed Tomography Angiography; Framingham Risk Score