Mitu Ovidiu, Crisan Adrian, Redwood Simon, Cazacu-Davidescu Ioan-Elian, Mitu Ivona, Costache Irina-Iuliana, Onofrei Viviana, Miftode Radu-Stefan, Costache Alexandru-Dan, Haba Cristian Mihai Stefan, Mitu Florin
1st Medical Department, Faculty of Medicine, University of Medicine and Pharmacy "Grigore T. Popa", 700115 Iasi, Romania.
Department of Cardiology, Clinical Emergency Hospital "Sf. Spiridon", 700111 Iasi, Romania.
J Clin Med. 2021 Mar 1;10(5):955. doi: 10.3390/jcm10050955.
The current cardiovascular disease (CVD) primary prevention guidelines prioritize risk stratification by using clinical risk scores. However, subclinical atherosclerosis may rest long term undetected. This study aimed to evaluate multiple subclinical atherosclerosis parameters in relation to several CV risk scores in asymptomatic individuals.
A cross-sectional, single-center study included 120 asymptomatic CVD subjects. Four CVD risk scores were computed: SCORE, Framingham, QRISK, and PROCAM. Subclinical atherosclerosis has been determined by carotid intima-media thickness (cIMT), pulse wave velocity (PWV), aortic and brachial augmentation indexes (AIXAo, respectively AIXbr), aortic systolic blood pressure (SBPao), and ankle-brachial index (ABI).
The mean age was 52.01 ± 10.73 years. For cIMT-SCORE was more sensitive; for PWV-Framingham score was more sensitive; for AIXbr-QRISK and PROCAM were more sensitive while for AIXao-QRISK presented better results. As for SBPao-SCORE presented more sensitive results. However, ABI did not correlate with any CVD risk score.
All four CV risk scores are associated with markers of subclinical atherosclerosis in asymptomatic population, except for ABI, with specific particularities for each CVD risk score. Moreover, we propose specific cut-off values of CV risk scores that may indicate the need for subclinical atherosclerosis assessment.
当前心血管疾病（CVD）一级预防指南通过使用临床风险评分对风险分层进行优先排序。然而，亚临床动脉粥样硬化可能长期未被发现。本研究旨在评估无症状个体中多个亚临床动脉粥样硬化参数与几种心血管风险评分之间的关系。
一项横断面单中心研究纳入了120例无症状CVD受试者。计算了四种CVD风险评分：SCORE、弗雷明汉姆评分、QRISK和PROCAM。通过颈动脉内膜中层厚度（cIMT）、脉搏波速度（PWV）、主动脉和肱动脉增强指数（分别为AIXAo和AIXbr）、主动脉收缩压（SBPao）和踝臂指数（ABI）来确定亚临床动脉粥样硬化。
平均年龄为52.01±10.73岁。对于cIMT，SCORE更敏感；对于PWV，弗雷明汉姆评分更敏感；对于AIXbr，QRISK和PROCAM更敏感，而对于AIXao，QRISK表现出更好的结果。至于SBPao，SCORE呈现出更敏感的结果。然而，ABI与任何CVD风险评分均无相关性。
除ABI外，所有四种心血管风险评分均与无症状人群中亚临床动脉粥样硬化标志物相关，每种CVD风险评分都有其特定的特点。此外，我们提出了心血管风险评分的特定临界值，这些临界值可能表明需要进行亚临床动脉粥样硬化评估。
