Diagnostic Value of Coronary Artery Plaque Detected on Computed Tomography Coronary Angiography in Healthy Adults with Zero to Low Coronary Calcium Scores

BackgroundWe evaluated the predictive value of traditional Framingham Risk Score (FRS) for subclinical coronary plaque detected by computed tomography coronary angiogram (CTCA) in asymptomatic patients with zero to low coronary artery calcium (CAC) scores.MethodsWe assessed 167 asymptomatic Taiwanese patients (mean age, 57 ± 11.2 years) who underwent CTCA as part of a health check-up evaluation, and examined the association between FRS, serum biomarkers, and coronary plaque assessed by CTCA.ResultsOf 127 patients with CAC scores between <100 and zero, 55 (43%) had coronary artery atheroma. Among the possible predictors of coronary atherosclerosis, FRS was an independent predictor (relative risk 1.25, 95% confidence interval 1.05–1.50, p < 0.05). A receiver-operating-characteristic curve analysis revealed that FRS is a good indicator of the presence of coronary plaque. The area under the FRS curve was 0.70 (p < 0.001), with 62% sensitivity and 63% specificity. Furthermore, adding high-sensitivity C-reactive protein with FRS provides limited advantages for predicting the presence of coronary plaque over FRS alone.ConclusionFRS could be helpful for physicians in assessing coronary artery disease risk for more targeted therapy among patients with zero to low CAC scores.