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A comparison of the various risk scores with carotid duplex imaging for assessing cardiovascular risk.

Abstract Information   Abstract Submitter: Doctor  Matangi  Murray - This email address is being protected from spambots. You need JavaScript enabled to view it. Event: EuroPRevent 2012 Status: Accepted Number: 10658 Title: A comparison of the various risk scores with carotid duplex imaging for assessing cardiovascular risk Evaluation Topic: 01.08 - Atherosclerosis/CAD (Prevention & Epidemiology) Acronym Abbreviation:   Acronym:   Category: Not Member of EACPR Options: No Options   Abstract Authors     M. Matangi1, DW. Armstrong1, D. Brouillard1 - (1) Kingston Heart Clinic, Kingston, Canada   Abstract Content 97%   Purpose. There are multiple risk scores for assessing cardiovascular (CV) risk. Despite excellent validation and physician knowledge very few physicians take the time to calculate any CV risk score because of limited time during patient encounters. Furthermore most risk scores underestimate CV risk, especially in women. Carotid duplex imaging is a validated and simple non-invasive method of assessing the presence or absence of atherosclerosis, an independent marker of CV risk. The purpose of our investigation was to compare the various CV risk scores with carotid duplex imaging. Methods. We compared low and intermediate risk patients using the Framingham Risk Score for coronary events (FRSC), with the expanded Framingham Risk Score for global CV risk (FRSG), the Reynolds Risk Score (RRS) and the JUPITER study criteria with carotid duplex imaging. High risk using the carotid study was deemed to be present if there was plaque present using the atherosclerosis risk in communities (ARIC) definition. Results. There were 113 patients, 57 females aged 66.7 ± 9.4 years and 56 males aged 57.2 ± 10.6. The results are seen in Table 1. Conclusions. As can be seen from the table there is increasing CV risk as one moves from the FRSC to the RRS, the FRSG and finally the JUPITER study criteria. What is much more obvious is that carotid duplex imaging dramatically increases the number of high-risk patients in both men and women. We believe that more patients will be appropriately treated with preventative drug therapy such as Statins if one simply uses carotid duplex imaging and dispenses with the various CV risk scores. Table 1. Females (n=57) FRSC RRS FRSG JUPITER Carotid study Low risk 48 48 24 40 15 Intermediate risk 9 6 23 0 0 High risk 0 3 10 17 42 Males (n=56) FRSC RRS FRSG JUPITER Carotid study Low risk 28 37 13 36 26 Intermediate risk 28 17 26 0 0 High risk 0 2 17 20 30 FRSC = Framingham risk score coronary, RRS = Reynolds risk score, FRSG = Framingham risk score global.