Coronary Artery Atherosclerosis Assessment Using Multi Detector Computed Tomography and its Correlation with Framingham Risk Score Among Symptomatic Patients with Chest Pain

Abstract
Background: A non-invasive assessment of coronary atherosclerosis by means of Framingham risk scoring (FRS) and multi-slice computed tomography coronary angiography (MSCT) could improve patients' risk stratification. However, the data is still limited on the strong association between FRS and imaging modality in the form of MSCT coronary angiog-raphy.
Aim of Work: To study the relationship between the extent of atherosclerotic affection among symptomatic patients with chest pain assessed by MDCT & the CAD risk as assessed by FRS.
Patients and Methods: This prospective cross sectional study took place between September 2017 and September 2018, at Kobry El-Kobba Military Hospital, and enrolled 150 patients who presented with chest pain. All patients were subjected to clinical assessment with FRS, after which they had undergone MDCT coronary angiography to diagnose the type of vessels affected, number of stenotic segments, as well as the volume of plaques obstructing the vessels.
Results: Most of our studied patients were males (70.7%) with mean±SD age 54.9±9.1 years. The mean ± SD FRS score was 15.6±11.3 with median value of 13.2. The majority of the patients were classified as low risk score. The patients with higher FRS showed more than 2 segments of stenosis and correlated strongly with the number of affected segments as well as the volume of detected plaques. Subjects who were in the higher risk group were significantly older, had disturbed lipid profile and showed the highest systolic blood pressure compared to the low and intermediate risk groups.
Conclusion: Framingham risk score is a well validated clinical score being moderately correlated with number of affected segments and volume of plagues detected in MDCT coronary angiography. Higher group of FRS was significantly associated with male gender, older subjects and disturbed lipid profile.