A Comparison of Assessment of Coronary Calcium vs Carotid Intima Media Thickness for Determination of Vascular Age and Adjustment of the Framingham Risk Score

The Framingham Risk Score (FRS) has become the standard tool to determine coronary heart disease (CHD) risk. Recent studies have demonstrated that FRS underestimates CHD risk in a number of patient populations. One strategy that has been proposed to improve the diagnostic accuracy of FRS is to use imaging of subclinical atherosclerosis to define a "vascular age" and use this age to calculate FRS. Both computed tomography assessment of coronary artery calcium (CAC) and ultrasonographic assessment of carotid intima-media thickness (CIMT) have been proposed as modalities that can be employed to assess vascular age. In the present study, the authors compared CAC vs CIMT for the assessment of vascular age and adjustment of FRS. In the cohort as a whole, CAC- and CIMT-derived vascular age correlated well. Further study is needed to verify the accuracy of vascular age-adjusted FRS using both CAC and CIMT and to determine whether there are specific patient demographics that favor either imaging modality.