CT May Be Superior to Framingham Score in Predicting Cardiovascular Event

Computed tomography measurements of calcification in the abdominal aorta can be more predictive than the Framingham score (FRS) for heart attacks and other adverse cardiovascular events, according to a study published in the journal Radiology.

Researchers from the University of Wisconsin School of Medicine and Public Health in Madison, and the Medical College of Wisconsin in Milwaukee, performed a retrospective study to determine if abdominal aortic calcification (AAC) at CT predicts cardiovascular events independent of FRS.

The researchers reviewed electronic health records for 451 asymptomatic women and 378 asymptomatic men (mean age, 57.9 years) who had undergone nonenhanced CT colonography screening between April 2004 and March 2005. The researchers were looking for subsequent cardiovascular events. The mean follow-up interval was 11.2 years.

The results showed 156 (18.8 percent) of the 829 patients had a major cardiovascular event, most often almost an average of 6.7 years after CT. The events included heart attack in 39 patients and death in 79. CT-based abdominal aortic calcification was a strong predictor of future cardiovascular events, outperforming the Framingham risk score. Abdominal aortic calcification was more than five times higher, on average, among those who had a cardiovascular event than those who didn’t.

“There are thousands of CT scans performed every day across the United States, so this gives us an opportunity to reach a lot of people,” lead author Stacy D. O’Connor, MD, assistant professor of radiology at the Medical College of Wisconsin, said in a release. “For instance, if someone is getting a scan for cholecystitis and we see abdominal aortic calcification on the CT, we can address things like blood pressure and cholesterol with the patient.”

The researchers plan to conduct larger studies and to move toward a fully automated protocol for more widespread implementation of the assessment.

“It’s our hope that these opportunistic measures can be added to reports for patients undergoing routine abdominal CT, regardless of the imaging indication,” Dr. O’Connor said.