Study Explores Framingham Score, CAD Relationship

Multislice computed tomography, stress testing may refine CAD risk assessment

20 sept 2009-- There is a strong correlation between Framingham Risk Score (FRS) and the development of functionally relevant obstructive coronary artery disease (CAD), according to research published in the Sept. 15 issue of the American Journal of Cardiology.

Gaetano Nucifora, M.D., of the Leiden University Medical Center in the Netherlands, and colleagues analyzed data from 255 subjects without known CAD who underwent multislice computed tomographic (MSCT) coronary angiography and stress testing with electrocardiographic exercise test or myocardial perfusion imaging, and calculated FRS from baseline characteristics.

The researchers found that coronary calcifications, based on calcium scoring, were more often found in subjects with a high FRS than a low score (74 versus 29 percent). Normal coronary arteries, based on MSCT coronary angiogram, were more often found in patients with a low FRS than a high score (62 versus 10 percent). Positive stress test results were also less likely in patients with a low FRS than a high FRS (4 versus 50 percent). And the prevalence of functionally relevant obstructive CAD increased along with increasing FRS.

"The present study describes the prevalence of positive stress testing compared to evidence of coronary atherosclerosis (by coronary artery calcium score and MSCT coronary angiography) across FRS categories. A significant increase in the prevalence of functionally relevant coronary lesions was observed in line with an increasing FRS," the authors write. "Selective use of MSCT coronary angiography and stress testing may refine the traditional risk assessment of CAD events, especially in patients deemed at intermediate and high risk."

Several co-authors reported financial relationships with medical equipment makers.

Abstract
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