[Global risk score and subclinical coronary atherosclerosis]

Area of Science:

• Cardiology
• Radiology
• Preventive Medicine

Background:

• Coronary heart disease risk is often assessed using global risk scores.
• Subclinical coronary atherosclerosis indicates early-stage disease.
• Accurate risk stratification is crucial for preventive cardiology.

Purpose of the Study:

• To investigate the prevalence of subclinical coronary atherosclerosis in individuals with elevated global risk scores.
• To evaluate the impact of subclinical atherosclerosis on risk reclassification, particularly in intermediate-risk groups.
• To assess the utility of electron-beam computed tomography (CT) in refining cardiovascular risk assessment.

Main Methods:

• Fifty healthy patients with elevated global risk scores underwent electron-beam computed tomography (CT).
• CT was used to detect subclinical coronary atherosclerosis.
• Patients were categorized by global risk score (high >20%, intermediate 10-20%).

Main Results:

• Subclinical coronary atherosclerosis was detected in 45 out of 50 patients (90%).
• Only 2 high-risk and 3 intermediate-risk patients showed no signs of atherosclerosis on CT.
• Twenty-nine of 32 intermediate-risk patients (91%) were reclassified as high risk due to subclinical atherosclerosis.

Conclusions:

• Electron-beam CT effectively identifies subclinical coronary atherosclerosis in patients with elevated risk scores.
• A significant proportion of intermediate-risk patients are reclassified as high risk upon CT evaluation.
• Integrating CT findings with global risk scores enhances cardiovascular risk stratification and preventive strategies.