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Published on: August 28, 2018
Determination of Vascular Age in Men Using the Coronary Calcium Score and its Impact on Restratification of
Ismael Polli1, Neide Maria Bruscato2,3, Protasio Lemos Da Luz4
1Universidade Federal do Rio Grande do Sul , Porto Alegre , RS - Brasil.
Insights
Arterial age, estimated by coronary calcium score (CCS), is a more reliable predictor of cardiovascular disease risk and progression than traditional scores. It accurately reclassifies risk and identifies individuals with higher atherosclerosis risk.
Area of Science:
- Preventive Cardiology
- Cardiovascular Imaging
- Risk Stratification
Background:
- Identifying asymptomatic individuals at risk of cardiovascular disease (CVD) is crucial for preventive cardiology.
- Coronary calcium score (CCS) estimates vascular age, a more reliable CVD risk determinant than chronological age.
Purpose of the Study:
- To reclassify cardiovascular risk using arterial age.
- To evaluate coronary calcium score (CCS) progression over time.
Main Methods:
- 150 asymptomatic men underwent two evaluations over 7.6 years.
- Patients were classified by traditional risk scores and arterial age.
- Association between variables and CCS progression was assessed (p < 0.05).
Main Results:
- Arterial age reclassified 29% to higher and 37% to lower risk categories compared to Framingham risk score (FRS).
- Arterial age reclassified 31% to higher and 36% to lower risk categories compared to ASCVD score.
- Initial arterial age strongly correlated with CCS progression (p < 0.001), unlike FRS (p = 0.862) or ASCVD (p = 0.153).
- High systolic blood pressure and low HDL were linked to greater CCS progression.
Conclusions:
- Arterial age outperforms FRS and ASCVD in cardiovascular risk stratification.
- Arterial age is superior in identifying individuals at higher risk of atherosclerosis progression.
Background:
Identifying asymptomatic individuals at risk of developing cardiovascular disease is one of the main goals of preventive cardiology. The coronary calcium score (CCS) makes it possible to estimate vascular age, which has shown to be more reliable than chronological age for determining cardiovascular risk.
Objectives:
To reclassify cardiovascular risk based on arterial age and evaluate CCS progression during follow-up.
Methods:
We included 150 asymptomatic men who underwent clinical and CCS evaluation in 2 evaluations with an interval of 7.6 years. We classified patients by traditional risk scores and arterial age. We evaluated which variables were associated with greater CCS progression during the period, considering a statistical significance level of 5% (p < 0.05).
Results:
The use of arterial age in the stratification of cardiovascular risk in comparison with the Framingham risk score (FRS) reclassified 29% of individuals to a higher risk category and 37% to a lower risk category. Regarding the American Heart Association and American College of Cardiology score (ASCVD), 31% were reclassified as higher risk and 36% as lower risk. The initial classification by arterial age was directly related to the progression of CCS throughout follow-up (p < 0.001). This was not observed for the FRS (p = 0.862) or ASCVD (p = 0.153). The individual variables most associated with CCS progression were high systolic blood pressure and low HDL.
Conclusion:
Cardiovascular risk stratification using arterial age showed a better association than the FRS and ASCVD in identifying individuals with higher risk of atherosclerosis progression.
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