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Published on: September 22, 2023
QRISK 3® and ASCVD Risk Calculator in Patients with Diabetes and Their Correlation with Coronary Artery Calcium
Subramanian Kannan1, Murali M B Venkataraman2, Salila S Chandorkar3
1Department of Endocrinology Diabetes and Metabolism, Narayana Hrudayalaya, Bengaluru, Karnataka, India.
Insights
Diabetes patients with high QRISK 3® or ASCVD scores may need further evaluation for cardiovascular disease risk using CT coronary artery calcium scoring. These scores help identify individuals needing closer monitoring for sub-clinical atherosclerosis.
Area of Science:
- Cardiology
- Diabetology
- Radiology
Background:
- Diabetes mellitus is a significant independent risk factor for developing asymptomatic cardiovascular disease (CVD).
- Risk assessment scores like QRISK 3® and ASCVD predict 10-year CVD risk.
- Coronary artery calcium scoring (CACS) via CT identifies sub-clinical atherosclerosis.
Purpose of the Study:
- To investigate the correlation between QRISK 3® and ASCVD risk scores and CACS in diabetic patients.
- To determine predictive cut-off values for QRISK 3® and ASCVD scores indicating moderate or accentuated CACS (≥100).
Main Methods:
- Prospective study of outpatients with diabetes and no prior coronary artery disease (CAD) or symptoms.
- Calculation of QRISK 3® and ASCVD risk scores.
- Performance of 256-slice cardiac CT to determine CACS using the Agatston method.
Main Results:
- A statistically significant positive correlation was observed between QRISK 3®/ASCVD scores and CACS (r=0.28, P=0.004/0.007).
- A QRISK® score >23 predicted CACS >100 with 85% sensitivity.
- An ASCVD score >10 predicted CACS >100 with 90% sensitivity.
Conclusions:
- QRISK 3® and ASCVD scores are valuable tools for triaging diabetic patients for further CVD risk assessment.
- CACS evaluation is recommended for diabetic patients with elevated QRISK 3® or ASCVD scores to identify sub-clinical atherosclerosis.
Introduction:
Diabetes mellitus is an independent risk factor for asymptomatic cardiovascular disease (CVD). The QRISK 3® score and atherosclerotic cardiovascular disease (ASCVD) risk scores determine the risk of developing CVD over 10 years. The CT coronary artery calcium score (CACS) is a non-invasive imaging modality that identifies sub-clinical atherosclerosis. We studied the correlation between the QRISK 3® and ASCVD scores and the CACS and determined the cut-off for QRISK 3® and ASCVD scores that corresponded to a moderate or accentuated CACS (≥100).
Methods:
In this prospective study, outpatients with diabetes and no prior coronary artery disease (CAD) or their equivalents, or having symptoms suggestive of angina or heart failure, had their QRISK 3® and ASCVD scores calculated. They subsequently underwent 256 slice cardiac CT, and CACS was calculated by the Agatston method.
Results:
A statistically significant correlation (r = 0.28) was found between QRISK 3® and ASCVD with CACS (P = 0.004 and P = 0.007, respectively). A QRISK® score >23 and ASCVD score >10 predicted a CACS score >100 with sensitivities of 85% and 90%, respectively.
Conclusion:
The QRISK 3® and ASCVD scores can be used to triage patients who require further evaluation with CACS to determine the risk of future CVD.
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