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Kim, Hyun, Kim, Yang, Kwon, and Bae: Carotid Intima Media Thickness is Associated with the Framingham Risk Score in Korean Patients with Coronary Arteriosclerosis - Association between IMT and Framingham Risk Score -
Original Article
Korean Circulation Journal

Korean Circulation Journal 2007; 37(9): 425-431.

Published online: 30 September 2008

DOI: https://doi.org/10.4070/kcj.2007.37.9.425

Carotid Intima Media Thickness is Associated with the Framingham Risk Score in Korean Patients with Coronary Arteriosclerosis - Association between IMT and Framingham Risk Score -

Ki Hong Kim, MD1, Dae Woo Hyun, MD1, Wuon-Shik Kim, PhD2, Jung Kyung Yang, MD1, Taek Geun Kwon, MD1, Jang Ho Bae, MD1

1Division of Cardiology, Heart Center, College of Medicine, Konyang University, Daejeon, Korea.

2Korean Research Institute of Standards and Science, Daejeon, Korea.

Corresponding author (janghobae@yahoo.co.kr)

Received 22 March 2007       Revised 7 June 2007       Accepted 16 July 2007

© 2007, The Korean Society of Circulation

Abstract

Background and Objectives

Carotid intima media thickness (IMT) is associated with an increased risk of cardiovascular events whereas the Framingham risk score (FRS) is globally used to evaluate cardiovascular risk. We sought to evaluate the relationship between carotid IMT and FRS in Korean patients with coronary arteriosclerosis.

Subjects and Methods

The study population consisted of angiographically proven 267 consecutive patients with coronary arteriosclerosis (mean age 59 years, 141 males). Carotid IMT was measured by high-resolution ultrasound and semiautomatic methods. The FRS was derived from the algorithm published in the National Cholesterol Education Program Adult Treatment Panel III guidelines (NCEP-ATP III) using age, gender, smoking, systolic blood pressure level, use of antihypertensive treatment and total and high-density lipoprotein cholesterol levels.

Results

Carotid IMT correlated with the FRS in men (r=0.307, p<0.001) and in women (r=0.429, p<0.001). The severity of CAD, which was graded on the number of stenosed major coronary arteries more than 50%, showed a significant positive correlation with the FRS (r=0.266, p<0.001) and carotid IMT (r=0.166, p=0.007). The mean value of the FRS in patients with carotid plaque was higher than in patients without carotid plaque (15.0±3.9 and 12.0±4.4, p<0.001). The FRS was independently associated with carotid IMT in men and women (β=6.433, p=0.001 and β=11.271, p<0.001, respectively).

Conclusion

The FRS for primary prevention was significantly associated with carotid IMT even in patients with CAD and also a correlation with the severity of CAD. The FRS may be helpful to predict the prognosis in patients with coronary arteriosclerosis such as carotid IMT and a prospective cohort study may be required to certify the usefulness of the FRS.

Keywords: Tunica intima, Tunica media, Atherosclerosis, Risk assessment

Figures and Tables

Fig. 1
Plots of age vs CCA IMT in men (A) and women (B). Regression lines are shown. There are statistically significant correlation between age and CCA IMT in men (r=0.187, p=0.027) and women (r=0.315, p<0.001). CCA: common carotid artery, IMT: intima media thickness.
kcj-37-425-g001
Fig. 2
Plots of Framingham risk scores vs CCA IMT in men (A) and women (B). Regression lines are shown. There are statistically significant correlation (p<0.001) between Framingham risk scores and CCA IMT in men (r=0.307) and women (r=0.429). CCA: common carotid artery, IMT: intima media thickness.
kcj-37-425-g002
Table 1
Clinical characteristics of the study subjects
kcj-37-425-i001

BMI: body mass index, BP: blood pressure, HDL: high density lipoprotein, LDL: low density lipoprotein

Table 2
CCA IMT according to the risk factors and medication
kcj-37-425-i002

CCA: common carotid artery, IMT: intima media thickness

Table 3
FRS according to the numbers of stenosed (>50%) coronary arteries
kcj-37-425-i003

CAD: coronary artery disease, FRS: Framingham risk score

Table 4
Independent factors of Framingham risk score (univariate analysis)
kcj-37-425-i004

*: analysed as dummy variables. β: regression coefficient, CAD: coronary artery disease, CCA: common carotid artery, IMT: intima media thickness

Table 5
Independent factors of Framingham risk score (multivariate analysis)
kcj-37-425-i005

*: analysed as dummy variables. β: regression coefficient, CAD: coronary artery disease, CCA: common carotid artery, IMT: intima media thickness

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