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

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.

Clinical Significance of Carotid Intima-Media Complex and Carotid Plaque Assessment by Ultrasound for the Prediction of Adverse Cardiovascular Events in Primary and Secondary Care Patients

“…The risk calculators may integrate CIMT measurement with CV risk factors [ 86 , 93 , 94 , 95 , 96 , 97 , 98 , 99 , 100 , 101 , 102 ]. The ARIC study published an adjusted FRS calculator incorporating mean-maximum CIMT from six carotid segments and plaque assessment to determine the probability of MI or death from CHD within 10 years [ 96 ].…”

“…Mitu et al found a relationship between CIMT and arterial stiffness with SCORE, FRS, QRISK, and PROCAM in an asymptomatic population [ 100 , 101 ]. The SCORE risk correlated better with CIMT, while the FRS and QRISK seemed more specific for increased arterial stiffness parameters [ 100 ].…”

“…Mitu et al found a relationship between CIMT and arterial stiffness with SCORE, FRS, QRISK, and PROCAM in an asymptomatic population [ 100 , 101 ]. The SCORE risk correlated better with CIMT, while the FRS and QRISK seemed more specific for increased arterial stiffness parameters [ 100 ]. Of note, arterial stiffness proved its clinical value for MACCE in various clinical scenarios, e.g., in patients with aortic valve stenosis [ 103 ].…”

Association of Helicobacter pylori Infection With Carotid Atherosclerosis in a Northern Chinese Population: A Cross-Sectional Study

“…CAS plays a role in the entire process from the subclinical phase to clinical CVD that is initially insidious until an ischemic accident occurs ( 7 ). Subclinical atherosclerosis is an early indicator of CVD, and identifying asymptomatic individuals is particularly important to reduce the disease burden ( 8 ). Previous studies tended to choose patients with clinical symptoms of atherosclerosis, and few studies focused on asymptomatic populations.…”

Special Issue “The Prevention and Treatment of Atherosclerosis”

“…Arterial properties such as vascular stiffness, carotid intima-media complex thickening (CIMT), and plaque formation are important, as non-traditional cardiovascular risk factors associated with risk of fatal and non-fatal cardiovascular events such as myocardial infarction, stroke, and heart failure episodes. Four papers addressed this clinically relevant problem [1][2][3][4].…”