Carotid Intima-Media Thickness Assessment in Refinement of the Framingham Risk Score: Can It Predict ST-Elevation Myocardial Infarction? A Pilot Study

Publication/Presentation Date

11-1-2013

Abstract

Patients who suffer a first ST-elevation myocardial infarction (STEMI) typically have fewer identifiable risk factors than those who suffer other types of acute coronary syndromes. As such, risk assessment tools such as the Framingham Risk Score (FRS) often fail to classify these patients as high risk. In this study, we tested the ability of assessment of carotid intima-media thickness (CIMT) to enhance the ability to identify patients who are at risk for STEMI, using a CIMT-derived "vascular age" in place of chronologic age in the calculation of FRS. We applied a CIMT-based vascular age to the assessment of FRS in a cohort of patients who presented with a first STEMI. Using CIMT-derived vascular age in place of chronologic age increased both the mean FRS and predicted 10 year cardiovascular event rate of the cohort. More importantly, the use of a CIMT-derived vascular age in the calculation of FRS significantly improved the ability to identify patients with STEMI as high risk and candidates for statin therapy based on ATPIII criteria (19.2% vs. 57.7%, P = 0.010). The use of CIMT to derive a vascular age may improve the ability of FRS to identify patients at risk for STEMI.

Volume

30

Issue

10

First Page

1209

Last Page

1213

ISSN

1540-8175

Disciplines

Cardiology | Medical Sciences | Medical Specialties | Medicine and Health Sciences

PubMedID

23937519

Department(s)

Department of Medicine, Cardiology Division, Department of Medicine Fellows and Residents

Document Type

Article

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