Correlation between coronary artery calcification by non-cardiac CT and Framingham score in young patients

Gabriel Lichtenstein, Amichai Perlman, Shoshana Shpitzen, Ronen Durst, Dorit Shaham, Eran Leitersdorf, Auryan Szalat*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Background Previous studies have established a correlation between coronary artery calcification (CAC) measured by ECG-gated chest computed tomography (CT) and cardiovascular disease. Recent reports which included asymptomatic patients suggest that CAC measured on non-ECG gated CT is similarly associated with cardiovascular risk. This study investigates the correlation between the Framingham Risk Score (FRS) and an incidental finding of CAC on a non-gated chest CT performed for non-cardiac indications in young and seemingly healthy adults. Methods A cross-sectional study that included 162 CT scans performed in young patients aged 18–50 years old for non-cardiac indications in our institution was conducted. CAC score (CACS) was calculated using the Agatston method. FRS was calculated and compared to the CACS using three different approaches. The correlations between the CACS and several specific factors (i.e. age, body mass index, smoking, statins, etc.), were also evaluated. Results Mean age of patients was 36.43 year old and 105 (64.8%) were male. We found a significant positive correlation between the CACS and the FRS in all three approaches (p<0.05). Increased age, smoking and statin use were the only individual factors clearly associated with an increase in CACS (p = 0.002, p = 0.045 and p = 0.009, respectively). Conclusion This is the first report indicating that incidental CACS identified in non-gated MDCT is also associated with cardiovascular risk evaluated by FRS in a young population. Our findings suggest that young asymptomatic individuals with incidental CAC should be seriously evaluated for cardiovascular risk factors despite presumption of belonging to a low cardiovascular risk category.

Original languageAmerican English
Article numbere0195061
JournalPLoS ONE
Issue number3
StatePublished - Mar 2018
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2018 Lichtenstein et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


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