Key result
CAC, ASCVD, and QRISK2 predict asymptomatic coronary stenosis, whereas the TyG score does not.
Why the study?
Cardiovascular diseases are the leading cause of death in Saudi Arabia, making cardiac risk-stratification scoring methods critical in primary healthcare settings to predict and potentially prevent fatal CVD outcomes.
Do cardiac risk scores (ASCVD, QRISK2, TyG) correlate with CACS in predicting cardiovascular events and stenosis in primary care patients?
Cohort (n=404)
No
Do cardiac risk scores (ASCVD, QRISK2, TyG) correlate with CACS in predicting cardiovascular events and stenosis in primary care patients?
Effect estimate: OR 1.003 (95% CI 1.005 -1.002)
p-value: p=<0.001
ASCVD and QRISK2 scores are consistent with CACS and are effective risk indicators for predicting cardiac events and stenosis in primary care patients.
ASCVD and QRISK2 associate with stenosis like CACS in primary care; supports risk score utility but leaves open prospective validation.
Background Cardiovascular diseases are the leading cause of death in Saudi Arabia, and cardiac risk-stratification scoring methods are critical in the primary healthcare setting to predict and potentially prevent the fatal outcomes of CVD. Therefore, this study aimed to examine the prognostic value of coronary artery calcium scoring (CACS) and other cardiac risk-stratification scores: arteriosclerotic cardiovascular disease (ASCVD) risk estimator, cardiovascular risk score (QRISK2), and triglyceride glucose index (TyG) in primary healthcare facilities in Riyadh, Saudi Arabia. Methods A retrospective cohort study was conducted at Family Medicine Clinics, and data on patient's demographics, medical records, and chronic illnesses obtained from the Integrated Clinical Information System (ICIS) database that were recorded between 2010 and 2019 were analyzed. We performed descriptive statistics, student's t-test, analysis of variance (ANOVA), Pearson correlation, Cohen's Kappa, and regression analyses. Results QRISK (p<0.001) and ASCVD (p<0.05) risk estimators positively correlated with the CACS score in predicting fatal and non-fatal cardiac outcomes while the TyG score had the lowest prediction ability among all the other risk estimators. CACS (OR = 1.003; 95% CI: 1.005 -1.002) (p<0.001), ASCVD (OR = 18.177; 95%CI: 214.578 - 1.540) (p=0.021), and QRISK2 (OR=154.796; 95%CI: 4137.356 - 5.792) (p=0.003) significantly predict stenosis unlike the TyG score's statistically insignificant prediction (p>0.05). Conclusion These findings show that ASCVD and QRISK2 are consistent with CACS and are effective risk indicators that could be used to predict cardiac-associated fatal and non-fatal cardiac events among primary care patients. This indicates that the integration of multiple risk scores, as necessary, can all contribute to more effective risk assessment and prevention of coronary artery diseases and related cardiovascular events.
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Alsulami et al. (2023) conducted a cohort in Asymptomatic with CAD risk factors (n=404). Coronary artery calcium scoring (CACS) vs. ASCVD, QRISK2, and TyG scores was evaluated on Coronary stenosis (OR 1.003, 95% CI 1.005 -1.002, p=<0.001). Coronary artery calcium scoring (OR 1.003), ASCVD (OR 18.177), and QRISK2 (OR 154.796) significantly predicted coronary stenosis in asymptomatic primary care patients, whereas the TyG score did not.
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