Abstract 13662: Different Estimation of Arterial Age and Cardiovascular Risk by Test of Subclinical Atherosclerosis
Background: As individual's arterial age assessed from atherosclerosis burden may vary according to the test used, we compared arterial age estimated by testing coronary artery calcium (CAC), carotid intima-media thickness (IMT) or aortic pulse wave velocity (PWV) as well as the capacity of these tests for modifying Framingham risk score (FRS).
Methods: Using data of healthy male subjects, obtained from general population-based studies, we determined nomograms for arterial age as a linear function of (i) log-transformed CAC (MESA Study), (ii) IMT (MESA Study), (iii) PWV (personal unpublished data). Based on these nomograms equations, we computed a multivariate function of arterial age on CAC, IMT and PWV. Then, in 141 asymptomatic men (age, 54±10 years; 10-year FRS,10±6%) having undergone simultaneous measures of CAC (64-slice MDCT), common carotid IMT (B mode ultrasound), and aortic PWV (mechanography), we applied these nomograms to estimate arterial age corresponding to CAC, IMT, PWV, and to the 3 combined tests. We modified FRS accordingly by entering arterial age instead of observed age into the NCEP ATP III risk algorithm.
Results: Arterial age minus chronological age, as well as FRS using arterial age minus FRS using chronological age, are shown by CAC, IMT, PWV test taken isolated or combined all together (Figure). Values are means (SEM) and compared by ANOVA and paired t-test.
Conclusion: Age gap between arterial and chronological age was 3 to 6 times higher with CAC than with IMT or PWV tests respectively, and increased modestly with the 3 combined tests with regard to CAC alone. As a consequence, FRS prediction was upgraded to a greater extent with CAC than with IMT or PWV but did not change with the 3 combined tests. So, CAC seems superior to IMT and PWV in predicting arterial risk and combination of three measures does not provide incremental risk modification with regard to CAC alone.
- © 2010 by American Heart Association, Inc.