American Heart Journal
Volume 150, Issue 6 , Pages 1276-1281 , December 2005

Women with a low Framingham risk score and a family history of premature coronary heart disease have a high prevalence of subclinical coronary atherosclerosis

  • Erin D. Michos, MD

      Affiliations

    • Division of Cardiology, Johns Hopkins Medical Institutions, Baltimore, MD
    • ,
  • Chandrasekhar R. Vasamreddy, MD

      Affiliations

    • Division of Internal Medicine, the Center for Health Promotion, Johns Hopkins Medical Institutions, Baltimore, Md
    • ,
  • Diane M. Becker, MPH, ScD

      Affiliations

    • Division of Internal Medicine, the Center for Health Promotion, Johns Hopkins Medical Institutions, Baltimore, Md
    • ,
  • Lisa R. Yanek, MPH

      Affiliations

    • Division of Internal Medicine, the Center for Health Promotion, Johns Hopkins Medical Institutions, Baltimore, Md
    • ,
  • Taryn F. Moy, MS

      Affiliations

    • Division of Internal Medicine, the Center for Health Promotion, Johns Hopkins Medical Institutions, Baltimore, Md
    • ,
  • Elliot K. Fishman, MD

      Affiliations

    • Division of Radiology, Johns Hopkins Medical Institutions, Baltimore, Md
    • ,
  • Lewis C. Becker, MD

      Affiliations

    • Division of Cardiology, Johns Hopkins Medical Institutions, Baltimore, MD
    • ,
  • Roger S. Blumenthal, MD, FACC

      Affiliations

    • Division of Cardiology, Johns Hopkins Medical Institutions, Baltimore, MD
    • Corresponding Author InformationReprint requests: Roger S. Blumenthal, MD, Ciccarone Preventive Cardiology Center, Blalock 524 C-Johns Hopkins Hospital, 600 N Wolfe St, Baltimore, MD 21287.

Received 13 September 2004 ,Accepted 14 February 2005.

References 

  1. American Heart Association. Heart disease and stroke statistics—2003 update. Dallas (Tex): American Heart Association; 2002;
  2. Wilson PW, D'Agostino RB, Levy D, et al. Prediction of coronary heart disease using risk factor categories. Circulation. 1998;97:1837–1847
  3. Grundy SM, Pasternak R, Greenland P. Assessment of cardiovascular risk by use of multiple-risk-factor assessment equations: a statement for healthcare professionals from the American Heart Association and the American College of Cardiology. J Am Coll Cardiol. 1999;34:1348–1359
  4. National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III) . Third report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III) final report. Circulation. 2002;106:3143–3421
  5. Myers RH, Kiely DK, Cupples LA, et al. Parental history is an independent risk factor for coronary artery disease: the Framingham study. Am Heart J. 1990;120:963–969
  6. Colditz GA, Stampfer MJ, Willett WC, et al. A prospective study of parental history of myocardial infarction and coronary heart disease in women. Am J Epidemiol. 1986;123:48–58
  7. Sesso HD, Lee IM, Gaziano JM, et al. Maternal and paternal history of myocardial infarction and risk of cardiovascular disease in men and women. Circulation. 2001;104:393–398
  8. Nasir K, Michos E, Rumberger J, et al. Coronary artery calcification and premature family history of coronary heart disease: sibling history is more strongly associated than parental history. Circulation. 2004;110:2150–2156
  9. Rumberger JA, Simons DB, Fitzpatrick LA, et al. Coronary artery calcium area by electron-beam computed tomography and coronary atherosclerotic plaque area: a histopathologic correlative study. Circulation. 1995;92:2157–2162
  10. Kaufmann RB, Peyser PA, Sheedy PF, et al. Quantification of coronary artery calcium by electron beam computed tomography for determination of severity of angiographic coronary artery disease in younger patients. J Am Coll Cardiol. 1995;25:626–632
  11. Haberl R, Becker A, Leber A, et al. Correlation of coronary calcification and angiographically documented stenoses in patients with suspected coronary artery disease: results of 1,674 patients. J Am Coll Cardiol. 2001;37:451–457
  12. Arad Y, Spadaro LA, Goodman K, et al. Predictive value of electron beam computed tomography of the coronary arteries: a 19-month follow-up of 1173 asymptomatic subjects. Circulation. 1996;93:1951–1953
  13. Raggi P, Cooil B, Callister TQ. Use of electron beam tomography data to develop models for prediction of hard coronary events. Am Heart J. 2001;141:375–382
  14. Raggi P, Shaw LJ, Berman DS, et al. Gender-based differences in the prognostic value of coronary calcification. J Womens Health. 2004;13:273–283
  15. Greenland P, LaBree L, Azen SP, et al. Coronary artery calcium score combined with Framingham score for risk prediction in asymptomatic individuals. JAMA. 2004;291:210–215
  16. Shaw LJ, Raggi P, Schisterman E, et al. Prognostic value of cardiac risk factors and coronary artery calcium screening for all-cause mortality. Radiology. 2003;228:826–833
  17. Blumenthal RS, Becker DM, Moy TF, et al. Exercise thallium tomography predicts future clinically manifest coronary heart disease in a high-risk asymptomatic population. Circulation. 1996;93:915–923
  18. Blumenthal RS, Becker DM, Yanek LR, et al. Detecting occult coronary disease in a high-risk asymptomatic population. Circulation. 2003;107:702–707
  19. Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972;18:499–502
  20. Agatston AS, Janowitz WR, Hildner FJ, et al. Quantification of coronary artery calcium using ultrafast computed tomography. J Am Coll Cardiol. 1990;15:827–832
  21. Rumberger JA, Brundage BH, Rader DJ, et al. Electron beam computed tomographic coronary calcium scanning: a review and guidelines for use in asymptomatic persons. Mayo Clin Proc. 1999;74:243–252
  22. Hoff JA, Chomka EV, Krainik AJ, et al. Age and gender distributions of coronary artery calcium detected by electron beam tomography in 35,246 adults. Am J Cardiol. 2001;87:1335–1339
  23. Wong ND, Sciammarella MG, Polk D, et al. The metabolic syndrome, diabetes, and subclinical atherosclerosis assessed by coronary calcium. J Am Coll Cardiol. 2003;41:1547–1553
  24. SAS Institute Inc . SAS/STAT user's guide, version 8.2. Cary (NC): SAS Institute Inc; 2001;
  25. Ridker PM, Buring JE, Shih J, et al. Prospective study of C-reactive protein and the risk of future cardiovascular events among apparently healthy women. Circulation. 1998;98:731–733
  26. Ridker PM, Rifai N, Rose L, et al. Comparison of C-reactive protein and low-density lipoprotein cholesterol levels in the prediction of first cardiovascular events. N Engl J Med. 2002;347:1557–1564
  27. Pasternak RC, Abrams J, Greenland P, et al. 34th Bethesda conference: task force #1—identification of coronary heart disease risk: is there a detection gap?. J Am Coll Cardiol. 2003;41:1863–1874
  28. Pearson TA, Blair SN, Daniels SR, et al. AHA guidelines for primary prevention of cardiovascular disease and stroke: 2002 update: consensus panel guide to comprehensive risk reduction for adult patients without coronary or other atherosclerotic vascular diseases. American Heart Association Science Advisory and Coordinating Committee. Circulation. 2002;106:388–391
  29. Hecht HS, Superko R. Electron beam tomography and national cholesterol education program guidelines in asymptomatic women. J Am Coll Cardiol. 2001;37:1506–1511
  30. Akosah KO, Schaper A, Cogbill C, et al. Preventing myocardial infarction in the young adult in the first place: how do the National Cholesterol Education Panel III guidelines perform?. J Am Coll Cardiol. 2003;41:1475–1479
  31. Kondos GT, Hoff JA, Sevrukov A, et al. Electron-beam tomography coronary artery calcium and cardiac events: a 37-month follow-up of 5635 initially asymptomatic low-to-intermediate-risk adults. Circulation. 2003;107:2571–2576
  32. Achenbach S, Nomayo A, Couturier G, et al. Relation between coronary calcium and 10-year risk scores in primary prevention patients. Am J Cardiol. 2003;92:1471–1475
  33. Greenland P, Smith SC, Grundy SM. Improving coronary heart disease risk assessment in asymptomatic people: role of traditional risk factors and noninvasive cardiovascular tests. Circulation. 2001;104:1863–1867
  34. Wong ND, Detrano RC, Diamond G, et al. Does coronary artery screening by electron beam computed tomography motivate potentially beneficial lifestyle behavior?. Am J Cardiol. 1996;78:1265–1266
  35. Nasir K, Braunstein JB, Rumberger JA, et al. Framingham risk equation markedly underestimates subclinical atherosclerosis risk in asymptomatic women. Circulation. 2004;110:3657;[abstract]

PII: S0002-8703(05)00207-3

doi: 10.1016/j.ahj.2005.02.037

American Heart Journal
Volume 150, Issue 6 , Pages 1276-1281 , December 2005

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