Prevalence of coronary artery disease across the Framingham risk categories: Coronary artery calcium scoring and MSCT coronary angiography

Gaetano Nucifora, Joanne D. Schuijf, Jacob M. van Werkhoven, J. Wouter Jukema, Roxana Djaberi, Arthur J.H.A. Scholte, Albert de Roos, Martin J. Schalij, Ernst E. van der Wall, Jeroen J. Bax

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Background: Non-invasive assessment of subclinical atherosclerosis by means of coronary artery calcium scoring (CACS) and multi-slice computed tomography (MSCT) coronary angiography could improve patients' risk stratification. However, data relating observations on CACS and MSCT coronary angiography to traditional risk assessment are scarce. Methodsand Results: In 314 consecutive outpatients (54 ± 13 years, 56% males) without known CAD, CACS and 64-slice MSCT coronary angiography were performed. According to the Framingham risk score (FRS), 51% of patients were at low, 24% at intermediate and 25% at high risk, respectively. MSCT angiograms showing atherosclerosis were classified as showing obstructive (≥50% luminal narrowing) CAD or not. Both CACS and MSCT coronary angiography showed a high prevalence of normal coronary arteries in low FRS patients (70% and 61%, respectively). An increase in the prevalence of CACS >400 (4% low vs 19% intermediate vs 36% high), CAD (39% low vs 79% intermediate vs 91% high), and obstructive CAD (15% low vs 43% intermediate vs 58% high) was observed across the FRS categories (P < .0001 for all comparisons). Conclusions: A strong positive relationship exists between FRS and the prevalence and extent of atherosclerosis. Especially in intermediate FRS patients, CACS and MSCT coronary angiography provide useful information on the presence of subclinical atherosclerosis.

Original languageEnglish
Pages (from-to)368-375
Number of pages8
JournalJournal of Nuclear Cardiology
Issue number3
Publication statusPublished or Issued - 2009


  • Calcium score
  • Coronary artery disease
  • Framingham risk score
  • MSCT coronary angiography
  • Risk stratification

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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