Comparing Coronary Artery Calcium Scoring With Cardiac Risk Scores for Predicting Cardiovascular Events in Primary Care Patients in Saudi Arabia

Amani A Alsulami; Abdullah H Alkhenizan; Kossay Elabd; Yaser Alendijani; Nora Alalem

doi:10.7759/cureus.50120

Comparing Coronary Artery Calcium Scoring With Cardiac Risk Scores for Predicting Cardiovascular Events in Primary Care Patients in Saudi Arabia

Cureus. 2023 Dec 7;15(12):e50120. doi: 10.7759/cureus.50120. eCollection 2023 Dec.

Authors

Amani A Alsulami¹, Abdullah H Alkhenizan¹, Kossay Elabd¹, Yaser Alendijani², Nora Alalem¹

Affiliations

¹ Family Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, SAU.
² Family Medicine and Polyclinics, King Faisal Specialist Hospital and Research Centre, Riyadh, SAU.

Abstract

Background Cardiovascular diseases are the leading cause of death in Saudi Arabia, and cardiac risk-stratification scoring methods are critical in the primary healthcare setting to predict and potentially prevent the fatal outcomes of CVD. Therefore, this study aimed to examine the prognostic value of coronary artery calcium scoring (CACS) and other cardiac risk-stratification scores: arteriosclerotic cardiovascular disease (ASCVD) risk estimator, cardiovascular risk score (QRISK2), and triglyceride glucose index (TyG) in primary healthcare facilities in Riyadh, Saudi Arabia. Methods A retrospective cohort study was conducted at Family Medicine Clinics, and data on patient's demographics, medical records, and chronic illnesses obtained from the Integrated Clinical Information System (ICIS) database that were recorded between 2010 and 2019 were analyzed. We performed descriptive statistics, student's t-test, analysis of variance (ANOVA), Pearson correlation, Cohen's Kappa, and regression analyses. Results QRISK (p<0.001) and ASCVD (p<0.05) risk estimators positively correlated with the CACS score in predicting fatal and non-fatal cardiac outcomes while the TyG score had the lowest prediction ability among all the other risk estimators. CACS (OR = 1.003; 95% CI: 1.005 -1.002) (p<0.001), ASCVD (OR = 18.177; 95%CI: 214.578 - 1.540) (p=0.021), and QRISK2 (OR=154.796; 95%CI: 4137.356 - 5.792) (p=0.003) significantly predict stenosis unlike the TyG score's statistically insignificant prediction (p>0.05). Conclusion These findings show that ASCVD and QRISK2 are consistent with CACS and are effective risk indicators that could be used to predict cardiac-associated fatal and non-fatal cardiac events among primary care patients. This indicates that the integration of multiple risk scores, as necessary, can all contribute to more effective risk assessment and prevention of coronary artery diseases and related cardiovascular events.

Keywords: arteriosclerotic cardiovascular disease; cardiovascular diseases; coronary artery calcium scoring; primary healthcare; triglyceride glucose index.