The Relationship between Cardiovascular Risk Scores and Several Markers of Subclinical Atherosclerosis in an Asymptomatic Population

J Clin Med. 2021 Mar 1;10(5):955. doi: 10.3390/jcm10050955.

Abstract

Background: The current cardiovascular disease (CVD) primary prevention guidelines prioritize risk stratification by using clinical risk scores. However, subclinical atherosclerosis may rest long term undetected. This study aimed to evaluate multiple subclinical atherosclerosis parameters in relation to several CV risk scores in asymptomatic individuals.

Methods: A cross-sectional, single-center study included 120 asymptomatic CVD subjects. Four CVD risk scores were computed: SCORE, Framingham, QRISK, and PROCAM. Subclinical atherosclerosis has been determined by carotid intima-media thickness (cIMT), pulse wave velocity (PWV), aortic and brachial augmentation indexes (AIXAo, respectively AIXbr), aortic systolic blood pressure (SBPao), and ankle-brachial index (ABI).

Results: The mean age was 52.01 ± 10.73 years. For cIMT-SCORE was more sensitive; for PWV-Framingham score was more sensitive; for AIXbr-QRISK and PROCAM were more sensitive while for AIXao-QRISK presented better results. As for SBPao-SCORE presented more sensitive results. However, ABI did not correlate with any CVD risk score.

Conclusions: All four CV risk scores are associated with markers of subclinical atherosclerosis in asymptomatic population, except for ABI, with specific particularities for each CVD risk score. Moreover, we propose specific cut-off values of CV risk scores that may indicate the need for subclinical atherosclerosis assessment.

Keywords: Framingham; PROCAM; QRISK; SCORE; cardiovascular risk; intima media thickness; pulse wave velocity; subclinical atherosclerosis.