Relations between digital thermal monitoring of vascular function, the Framingham risk score, and coronary artery calcium score

Ahmadi, Naser; Hajsadeghi, Fereshteh; Gul, Khawar; Vane, Jackson; Usman, Nudrat; Flores, Ferdinand; Nasir, Khurram; Hecht, Harvey; Naghavi, Morteza; Budoff, Matthew

doi:10.1016/j.jcct.2008.09.001

« Previous Next »Journal of Cardiovascular Computed Tomography
Volume 2, Issue 6 , Pages 382-388, November 2008

Relations between digital thermal monitoring of vascular function, the Framingham risk score, and coronary artery calcium score

Naser Ahmadi, MD
- Los Angeles Biomedical Research Institute at Harbor UCLA Medical Center, 1124 West Carson Street, RB2, Torrance, CA 90502, USA
Fereshteh Hajsadeghi, MD
- Los Angeles Biomedical Research Institute at Harbor UCLA Medical Center, 1124 West Carson Street, RB2, Torrance, CA 90502, USA
Khawar Gul, MD
- Los Angeles Biomedical Research Institute at Harbor UCLA Medical Center, 1124 West Carson Street, RB2, Torrance, CA 90502, USA
Jackson Vane, MS
- Los Angeles Biomedical Research Institute at Harbor UCLA Medical Center, 1124 West Carson Street, RB2, Torrance, CA 90502, USA
Nudrat Usman, MD
- Los Angeles Biomedical Research Institute at Harbor UCLA Medical Center, 1124 West Carson Street, RB2, Torrance, CA 90502, USA
Ferdinand Flores, BS
- Los Angeles Biomedical Research Institute at Harbor UCLA Medical Center, 1124 West Carson Street, RB2, Torrance, CA 90502, USA
Khurram Nasir, MD, MPH
- Society for Heart Attack Prevention and Eradication, Houston, TX, USA
Harvey Hecht, MD
- Lenox Hill Hospital, New York, NY, USA
Morteza Naghavi, MD
- Society for Heart Attack Prevention and Eradication, Houston, TX, USA
Matthew Budoff, MD
- Los Angeles Biomedical Research Institute at Harbor UCLA Medical Center, 1124 West Carson Street, RB2, Torrance, CA 90502, USA
- Corresponding author.

Received 8 July 2008; accepted 18 September 2008. published online 29 September 2008.

Background

Digital thermal monitoring (DTM) of vascular function was shown to correlate with the presence of known coronary artery disease (CAD).

Objective

We evaluated whether DTM can identify at-risk, asymptomatic patients with significant coronary artery calcium (CAC) or increased Framingham risk score (FRS).

Methods

Two hundred thirty-three consecutive asymptomatic subjects (58 ± 11 years; 62% men) without known CAD underwent DTM, CAC, and FRS calculation. DTM measurements were obtained during and after a 5-minute suprasystolic arm-cuff occlusion. After cuff-deflation temperature rebound (TR) and area under the temperature curve (AUC) were measured and correlated with FRS and CAC.

Results

TR was lower in patients with FRS > 20% and CAC ≥ 100 as compared with FRS < 10% and CAC < 10, respectively (P < 0.05). After adjustment for age, sex, and traditional cardiac risk factors, the odds ratio of the lowest compared with the upper 2 tertiles of TR was 3.96 for FRS ≥ 20% and 2.37 for CAC ≥ 100 compared with low-risk cohorts. The area under the receiver operating characteristic (ROC) curve to predict CAC ≥ 100 increased significantly from 0.66 for FRS to 0.79 for TR to 0.89 for TR + FRS.

Conclusions

Vascular dysfunction measured by DTM strongly correlates with FRS and CAC independent of age, sex, and traditional cardiac risk factors and was superior to FRS for the prediction of significant CAC.

Keywords: Coronary artery calcium score, Coronary artery disease, Digital thermal monitoring, Framingham risk score