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
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Article info
Publication history
Published online: September 29, 2008
Accepted:
September 18,
2008
Received:
July 8,
2008
Footnotes
Conflict of interest: Dr. Matthew Budoff is on the speakers bureau for Coeneral Electric.
Identification
Copyright
© 2008 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.
