Women with a low Framingham risk score and a family history of premature coronary heart disease have a high prevalence of subclinical coronary atherosclerosis

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Abstract

Background: The Framingham risk estimation (FRE) serves as the basis for identifying which asymptomatic adults should be treated with aspirin and lipid-lowering therapy in primary prevention. However, the FRE generally yields low estimates of 10-year "hard" coronary heart disease (CHD) event risk with few women (20%) (n = 0). Significant subclinical atherosclerosis was defined as age-sex adjusted >75th percentile CAC scores. Results: Ninety-eight percent were at low risk (mean FRE of only 2% ± 2%). However, 40% had detectable CAC, 12% had CAC >100, and 6% had CAC ≥400. Based on CAC score percentiles, 32% had significant subclinical atherosclerosis and 17% ranked above the 90th percentile. Conclusion: Among women classified as low risk by FRE, a third had significant subclinical atherosclerosis. Sisters of probands with premature CHD appear to be a high-risk group and may warrant noninvasive screening for subclinical atherosclerosis to appropriately target individuals for more aggressive primary prevention therapy than what is currently recommended.

Original languageEnglish (US)
Pages (from-to)1276-1281
Number of pages6
JournalAmerican Heart Journal
Volume150
Issue number6
DOIs
StatePublished - Dec 2005

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Coronary Disease
Coronary Artery Disease
Atherosclerosis
Primary Prevention
Aspirin
Siblings
Lipids
Therapeutics

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

@article{66ddb3a5fb9a44ffa9e1bdb335a41e86,
title = "Women with a low Framingham risk score and a family history of premature coronary heart disease have a high prevalence of subclinical coronary atherosclerosis",
abstract = "Background: The Framingham risk estimation (FRE) serves as the basis for identifying which asymptomatic adults should be treated with aspirin and lipid-lowering therapy in primary prevention. However, the FRE generally yields low estimates of 10-year {"}hard{"} coronary heart disease (CHD) event risk with few women (20{\%}) (n = 0). Significant subclinical atherosclerosis was defined as age-sex adjusted >75th percentile CAC scores. Results: Ninety-eight percent were at low risk (mean FRE of only 2{\%} ± 2{\%}). However, 40{\%} had detectable CAC, 12{\%} had CAC >100, and 6{\%} had CAC ≥400. Based on CAC score percentiles, 32{\%} had significant subclinical atherosclerosis and 17{\%} ranked above the 90th percentile. Conclusion: Among women classified as low risk by FRE, a third had significant subclinical atherosclerosis. Sisters of probands with premature CHD appear to be a high-risk group and may warrant noninvasive screening for subclinical atherosclerosis to appropriately target individuals for more aggressive primary prevention therapy than what is currently recommended.",
author = "Michos, {Erin Donnelly} and Vasamreddy, {Chandrasekhar R.} and Becker, {Diane M} and Lisa Yanek and Moy, {Taryn F.} and Fishman, {Elliot K} and Lewis Becker and Blumenthal, {Roger S}",
year = "2005",
month = "12",
doi = "10.1016/j.ahj.2005.02.037",
language = "English (US)",
volume = "150",
pages = "1276--1281",
journal = "American Heart Journal",
issn = "0002-8703",
publisher = "Mosby Inc.",
number = "6",

}

TY - JOUR

T1 - Women with a low Framingham risk score and a family history of premature coronary heart disease have a high prevalence of subclinical coronary atherosclerosis

AU - Michos, Erin Donnelly

AU - Vasamreddy, Chandrasekhar R.

AU - Becker, Diane M

AU - Yanek, Lisa

AU - Moy, Taryn F.

AU - Fishman, Elliot K

AU - Becker, Lewis

AU - Blumenthal, Roger S

PY - 2005/12

Y1 - 2005/12

N2 - Background: The Framingham risk estimation (FRE) serves as the basis for identifying which asymptomatic adults should be treated with aspirin and lipid-lowering therapy in primary prevention. However, the FRE generally yields low estimates of 10-year "hard" coronary heart disease (CHD) event risk with few women (20%) (n = 0). Significant subclinical atherosclerosis was defined as age-sex adjusted >75th percentile CAC scores. Results: Ninety-eight percent were at low risk (mean FRE of only 2% ± 2%). However, 40% had detectable CAC, 12% had CAC >100, and 6% had CAC ≥400. Based on CAC score percentiles, 32% had significant subclinical atherosclerosis and 17% ranked above the 90th percentile. Conclusion: Among women classified as low risk by FRE, a third had significant subclinical atherosclerosis. Sisters of probands with premature CHD appear to be a high-risk group and may warrant noninvasive screening for subclinical atherosclerosis to appropriately target individuals for more aggressive primary prevention therapy than what is currently recommended.

AB - Background: The Framingham risk estimation (FRE) serves as the basis for identifying which asymptomatic adults should be treated with aspirin and lipid-lowering therapy in primary prevention. However, the FRE generally yields low estimates of 10-year "hard" coronary heart disease (CHD) event risk with few women (20%) (n = 0). Significant subclinical atherosclerosis was defined as age-sex adjusted >75th percentile CAC scores. Results: Ninety-eight percent were at low risk (mean FRE of only 2% ± 2%). However, 40% had detectable CAC, 12% had CAC >100, and 6% had CAC ≥400. Based on CAC score percentiles, 32% had significant subclinical atherosclerosis and 17% ranked above the 90th percentile. Conclusion: Among women classified as low risk by FRE, a third had significant subclinical atherosclerosis. Sisters of probands with premature CHD appear to be a high-risk group and may warrant noninvasive screening for subclinical atherosclerosis to appropriately target individuals for more aggressive primary prevention therapy than what is currently recommended.

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U2 - 10.1016/j.ahj.2005.02.037

DO - 10.1016/j.ahj.2005.02.037

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EP - 1281

JO - American Heart Journal

JF - American Heart Journal

SN - 0002-8703

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ER -