The Correlation between Thai Cardiovascular Risk Score and the Multi-Ethnic Study of Atherosclerosis (MESA) Risk Score in Thai Populations

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Kunlatuch Chopchai
Chaisiri Wanlapakorn
Suwara Issaragrisil
Teetouch Ananwattanasuk
Padoemwut Teerawongsakul

Abstract

Objective: The purpose of this study was to examine the relationship between the Thai cardiovascular risk score (TCVRS) and the Multi-Ethnic Study of Atherosclerosis (MESA) risk score and predictors of high CAC score in Thai adults without a history of atherosclerotic cardiovascular disease.


Methods: This is a cross-sectional study assessing chest computed tomography scan patients without established atherosclerotic disease in Vajira Hospital, Thailand from July to December 2018. The TCVRS, MESA, and CAC scores were analyzed to estimate coronary heart disease risk. The predictive factors for the high CAC score were assessed by using univariate and multivariable analysis.


Results: The total of 84 patients were enrolled (mean age, 55.1 years and female, 65.5%), mostly zero CAC (46.4%). The correlation of TCVRS and MESA risk score was stronger than FRS and MESA risk score by r = 0.818; p<0.001 and r = 0.747; p< 0.001, respectively. The agreements were acceptable with mean difference = -0.73, SD = 0.242 and -3.78, SD = 0.539, respectively. In multivariate analysis, diabetes mellitus (odds ratio [OR]: 28.39, 95% CI:1.92-420.09; p = 0.015) and age ≥ 60 years (OR: 38.26, 95% CI:13.76-389.49; p = 0.002) were independent risk factors to predict high CAC.


Conclusion: There is a strong correlation between TCVRS and MESA risk score in Thai populations, but the MESA risk score may have a lower estimated coronary heart disease risk in Thai patients, especially in patients with multiple risk factors for coronary heart disease. Diabetes mellitus was the strongest predictor of high CAC.

Article Details

How to Cite
Chopchai, kunlatuch, Wanlapakorn, C., Issaragrisil, S., Ananwattanasuk, T., & Teerawongsakul, P. (2022). The Correlation between Thai Cardiovascular Risk Score and the Multi-Ethnic Study of Atherosclerosis (MESA) Risk Score in Thai Populations. Vajira Medical Journal : Journal of Urban Medicine, 66(2), 125–136. https://doi.org/10.14456/vmj.2022.13
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Original Articles

References

Wilson PW, D'Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB. Prediction of coronary heart disease using risk factor categories. Circulation 1998;97(18):1837-47.

Brindle P, Beswick A, Fahey T, Ebrahim S. Accuracy and impact of risk assessment in the primary prevention of cardiovascular disease: a systematic review. Heart 2006;92(12):1752-9.

Pletcher MJ, Sibley CT, Pignone M, Vittinghoff E, Greenland P. Interpretation of the coronary artery calcium score in combination with conventional cardiovascular risk factors: the Multi-Ethnic Study of Atherosclerosis (MESA). Circulation 2013;128(10):1076-84.

Hong C, Bae KT, Pilgram TK, Suh J, Bradley D. Coronary artery calcium measurement with multi-detector row CT: in vitro assessment of effect of radiation dose. Radiology 2002;225(3):901-6.

Yoon HC, Greaser LE , Mather R, Sinha S, McNitt-Gray MF, Goldin JG. Coronary artery calcium: alternate methods for accurate and reproducible quantitation. Acad Radiol 1997;4(10):666-73.

Agatston AS, Janowitz WR, Hildner FJ, Zusmer NR, Viamonte M Jr, Detrano R. Quantification of coronary artery calcium using ultrafast computed tomography. J Am Coll Cardiol 1990;15(4):827-32.

Diederichsen SZ, Grønhøj MH, Mickley H, Gerke O, Steffensen FH, Lambrechtsen J, et al. CT-Detected Growth of Coronary Artery Calcification in Asymptomatic Middle-Aged Subjects and Association With 15 Biomarkers. JACC Cardiovasc Imaging 2017;10(8):858-66.

Okwuosa TM, Greenland P, Ning H, Liu K, Bild DE, Burke GL, et al. Distribution of coronary artery calcium scores by Framingham 10-year risk strata in the MESA (Multi-Ethnic Study of Atherosclerosis) potential implications for coronary risk assessment. J Am Coll Cardiol 2011;57(18):1838-45.

Polonsky TS, McClelland RL, Jorgensen NW, Bild DE, Burke GL, Guerci AD, et al. Coronary artery calcium score and risk classification for coronary heart disease prediction. JAMA 2010;303(16):1610-6.

Kronmal RA, McClelland RL, Detrano R, Shea S, Lima JA, Cushman M, et al. Risk factors for the progression of coronary artery calcification in asymptomatic subjects: results from the Multi-Ethnic Study of Atherosclerosis (MESA). Circulation 2007;115(21):2722-30.

Arad Y, Goodman KJ, Roth M, Newstein D, Guerci AD. Coronary calcification, coronary disease risk factors, C-reactive protein, and atherosclerotic cardiovascular disease events: the St. Francis Heart Study. J Am Coll Cardiol 2005;46:158-65.

Bild DE, Bluemke DA, Burke GL, Detrano R, Diez Roux AV, Folsom AR, Greenland P, et al. Multi-Ethnic Study of Atherosclerosis: objectives and design. Am J Epidemiol 2002; 156(9):871-81.

Peduzzi P, Concato J, Kemper E, Holford TR, Feinstein AR. A simulation study of the number of events per variable in logistic regression analysis. J Clin Epidemiol 1996;49(12):1373-9.

Hecht HS, Cronin P, Blaha MJ, Budoff MJ, Kazerooni EA, Narula J, Yankelevitz D, Abbara S. 2016 SCCT/STR guidelines for coronary artery calcium scoring of noncontrast noncardiac chest CT scans: A report of the Society of Cardiovascular Computed Tomography and Society of Thoracic Radiology. J Cardiovasc Comput Tomogr 2017;11:74-84.

Vathesatogkit P, Woodward M, Tanomsup S, Ratanachaiwong W, Vanavanan S, Yamwong S, et al. Cohort profile: the electricity generating authority of Thailand study. Int J Epidemiol 2012;41(2):359-65.