The Prognostic Value of Coronary Arteries Calcium Scoring in a Primary Health Care Setting in Riyadh, Saudi Arabia: A Retrospective Cohort Study

被引:1
作者
Alalem, Nora [1 ]
Alkhenizan, Abdullah [2 ]
Basudan, Loay [1 ]
Amin, Fareeha [1 ]
Alsoghayer, Suad [1 ]
机构
[1] King Faisal Specialist Hosp & Res Ctr, Family Med, Riyadh, Saudi Arabia
[2] King Faisal Specialist Hosp & Res Ctr, Family Med & Polyclin, Riyadh, Saudi Arabia
关键词
ascvd risk; cardiac risk; qrisk; coronary artery calcium score; coronary risk; CARDIAC COMPUTED-TOMOGRAPHY; AMERICAN-HEART-ASSOCIATION; CARDIOVASCULAR RISK; DISEASE EVENTS; TASK-FORCE; CALCIFICATION; ANGIOGRAPHY; PROGRESSION; CARDIOLOGY; RADIOLOGY;
D O I
10.7759/cureus.25623
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background/Purpose: Coronary Artery Calcium Scoring (CACS) by CT, the American Atherosclerotic Cardiovascular Disease (ASCVD) Score, and the British Cardiovascular Risk (QRISK2) score are the most frequently used cardiovascular risk stratification scores to predict cardiac outcomes and aid in the decision of implementing preventative and/or interventional measures. The aim of this study is to assess CACS, ASCVD score, QRISK2 score, and their capacity to predict cardiovascular events among family medicine patients in King Faisal Specialist Hospital and Research Centre (KFSH&RC), Riyadh, Saudi Arabia. Methodology: All medical records of patients (18 years and above) who had a CACS done in Family Medicine Clinics at KFSH&RC from January 2010 to March 2018 were reviewed, retrospectively. The study variables included demographics, comorbidities, CACS, ASCVD Score, QRISK2 score, and cardiovascular events. Results: We included 218 patients. Our study population included: 77% men, a mean age of 51 years (SD +/- 8), and a mean BMI of 29 kg/m(2) (SD +/- 5). CACS was significantly associated with coronary events (p-value < .05). There was significant association between high CACS (>400) and family history of cardiac disease (p-value = .006), prior cardiovascular events (p-value = .01) and advancing age (p-value < .001). High concordance was found between QRISK2 score and CACS (90.6%), and moderate concordance between ASCVD score and CACS (69.4%). Moderate concordance was found between ASCVD score and QRISK2 score (74.3%). The majority of the subjects (88%) fell into the low-risk group (CACS <100) with (63%) having a CACS of zero. Conclusion: QRISK2 cardiac assessment tool provides better risk assessment and higher concordance with CACS. To improve cost-effectiveness and minimize unnecessary radiation exposure, QRISK2 scoring should be implemented for initial cardiovascular risk stratification prior to ordering the CACS imaging modality.
引用
收藏
页数:7
相关论文
共 27 条
[1]  
Abazid R, 2017, J SAUDI HEART ASSOC, V29, P96, DOI 10.1016/j.jsha.2016.06.002
[2]   QUANTIFICATION OF CORONARY-ARTERY CALCIUM USING ULTRAFAST COMPUTED-TOMOGRAPHY [J].
AGATSTON, AS ;
JANOWITZ, WR ;
HILDNER, FJ ;
ZUSMER, NR ;
VIAMONTE, M ;
DETRANO, R .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1990, 15 (04) :827-832
[3]  
[Anonymous], 2020, The top 10 causes of death
[4]   Coronary calcification, coronary disease risk factors, C-reactive protein, and atherosclerotic cardiovascular disease events - The St. Francis Heart Study [J].
Arad, Y ;
Goodman, KJ ;
Roth, M ;
Newstein, D ;
Guerci, AD .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2005, 46 (01) :158-165
[5]   Predictive value of coronary calcifications for future cardiac events in asymptomatic individuals [J].
Becker, Alexander ;
Leber, Alexander ;
Becker, Christoph ;
Knez, Andreas .
AMERICAN HEART JOURNAL, 2008, 155 (01) :154-160
[6]   Long-term prognosis associated with coronary calcification - Observations from a registry of 25,253 patients [J].
Budoff, Matthew J. ;
Shaw, Leslee J. ;
Liu, Sandy T. ;
Weinstein, Steven R. ;
Mosler, Tristen P. ;
Tseng, Philip H. ;
Flores, Ferdinand R. ;
Callister, Tracy Q. ;
Raggi, Paolo ;
Berman, Daniel S. .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2007, 49 (18) :1860-1870
[7]   Assessment of coronary artery disease by cardiac computed tomography - A scientific statement from the American Heart Association committee on cardiovascular imaging and intervention, council on cardiovascular radiology and intervention, and Committee on Cardiac Imaging, Council on Clinical Cardiology [J].
Budoff, Matthew J. ;
Achenbach, Stephan ;
Blumenthal, Roger S. ;
Carr, J. Jeffrey ;
Goldin, Jonathan G. ;
Greenland, Philip ;
Guerci, Alan D. ;
Lima, Joao A. C. ;
Rader, Daniel J. ;
Rubin, Geoffrey D. ;
Shaw, Leslee J. ;
Wiegers, Susan E. .
CIRCULATION, 2006, 114 (16) :1761-1791
[8]   Progression of Coronary Artery Calcium Predicts All-Cause Mortality [J].
Budoff, Matthew J. ;
Hokanson, John E. ;
Nasir, Khurram ;
Shaw, Leslee J. ;
Kinney, Gregory L. ;
Chow, David ;
DeMoss, Daniel ;
Nuguri, Vivek ;
Nabavi, Vahid ;
Ratakonda, Raghu ;
Berman, Daniel S. ;
Raggi, Paolo .
JACC-CARDIOVASCULAR IMAGING, 2010, 3 (12) :1229-1236
[9]   Coronary Calcium Predicts Events Better With Absolute Calcium Scores Than Age-Sex-Race/Ethnicity Percentiles MESA (Multi-Ethnic Study of Atherosclerosis) [J].
Budoff, Matthew J. ;
Nasir, Khurram ;
McClelland, Robyn L. ;
Detrano, Robert ;
Wong, Nathan ;
Blumenthal, Roger S. ;
Kondos, George ;
Kronmal, Richard A. .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2009, 53 (04) :345-352
[10]   An Analysis of Calibration and Discrimination Among Multiple Cardiovascular Risk Scores in a Modern Multiethnic Cohort [J].
DeFilippis, Andrew P. ;
Young, Rebekah ;
Carrubba, Christopher J. ;
McEvoy, John W. ;
Budoff, Matthew J. ;
Blumenthal, Roger S. ;
Kronmal, Richard A. ;
McClelland, Robyn L. ;
Nasir, Khurram ;
Blaha, Michael J. .
ANNALS OF INTERNAL MEDICINE, 2015, 162 (04) :266-+