Framingham risk score in predicting increased carotid intima-media thickness on ultrasound: identifying patients with subclinical atherosclerosis at high risk

Tools to identify patients at high risk for subclinical atherosclerosis (subAS) are lacking. We evaluated the Framingham risk score (FRS) for identifying high-risk subAS patients. We enrolled 68 subAS patients and 150 healthy controls. Carotid intima-media thickness (cIMT) was measured via ultrasound in both common carotid arteries, and FRS was calculated. The FRS was low (median, 3.98%). Mean cIMTs for both long and short axes in subAS patients were higher than in healthy individuals (𝑃 < 0.001). In subAS patients, FRS significantly correlated with increased cIMT in long (high-risk OR = 11.61, 95% CI = 2.66–65.95) and short (high-risk OR = 7.11, 95% CI = 1.73–37.79) axes. FRS predicted increased cIMT in long (AUC = 0.713) and short (AUC = 0.673) axes in subAS patients, but not in healthy controls (𝑃 > 0.05). FRS is associated with high-risk subAS patients, but complementary noninvasive imaging data are needed.