Kannan Subramanian, Venkataraman Murali M B, Chandorkar Salila S
Department of Endocrinology Diabetes and Metabolism, Narayana Hrudayalaya, Bengaluru, Karnataka, India.
Department of Internal Medicine, Narayana Hrudayalaya, Bengaluru, Karnataka, India.
Indian J Endocrinol Metab. 2024 Nov-Dec;28(6):639-644. doi: 10.4103/ijem.ijem_27_24. Epub 2024 Dec 30.
Diabetes mellitus is an independent risk factor for asymptomatic cardiovascular disease (CVD). The QRISK 3 score and atherosclerotic cardiovascular disease (ASCVD) risk scores determine the risk of developing CVD over 10 years. The CT coronary artery calcium score (CACS) is a non-invasive imaging modality that identifies sub-clinical atherosclerosis. We studied the correlation between the QRISK 3 and ASCVD scores and the CACS and determined the cut-off for QRISK 3 and ASCVD scores that corresponded to a moderate or accentuated CACS (≥100).
In this prospective study, outpatients with diabetes and no prior coronary artery disease (CAD) or their equivalents, or having symptoms suggestive of angina or heart failure, had their QRISK 3 and ASCVD scores calculated. They subsequently underwent 256 slice cardiac CT, and CACS was calculated by the Agatston method.
A statistically significant correlation (r = 0.28) was found between QRISK 3 and ASCVD with CACS ( = 0.004 and = 0.007, respectively). A QRISK score >23 and ASCVD score >10 predicted a CACS score >100 with sensitivities of 85% and 90%, respectively.
The QRISK 3 and ASCVD scores can be used to triage patients who require further evaluation with CACS to determine the risk of future CVD.
糖尿病是无症状性心血管疾病（CVD）的独立危险因素。QRISK 3评分和动脉粥样硬化性心血管疾病（ASCVD）风险评分可确定10年内发生CVD的风险。CT冠状动脉钙化评分（CACS）是一种识别亚临床动脉粥样硬化的非侵入性成像方法。我们研究了QRISK 3评分和ASCVD评分与CACS之间的相关性，并确定了与中度或重度CACS（≥100）相对应的QRISK 3评分和ASCVD评分的临界值。
在这项前瞻性研究中，对无既往冠状动脉疾病（CAD）或其等效疾病、或有提示心绞痛或心力衰竭症状的糖尿病门诊患者计算其QRISK 3评分和ASCVD评分。随后，他们接受了256层心脏CT检查，并采用阿加斯顿方法计算CACS。
QRISK 3评分和ASCVD评分与CACS之间存在统计学显著相关性（r = 0.28）（分别为P = 0.004和P = 0.007）。QRISK评分>23和ASCVD评分>10预测CACS评分>100，敏感性分别为85%和90%。
QRISK 3评分和ASCVD评分可用于对需要进一步进行CACS评估以确定未来CVD风险的患者进行分类。
