Clinical and imaging parameters to predict cardiovascular outcome in asymptomatic subjects

We aimed to compare the prognostic power of clinical parameters, biomarkers and imaging parameters in predicting cardiovascular outcome in asymptomatic healthy population. A total of 5,182 asymptomatic patients who visited Health Promotion Center at Seoul National University Bundang Hospital between January 2006 and September 2008 and had coronary computed tomography angiography were evaluated. All cardiovascular events including cardiac death, acute coronary syndrome and stroke were evaluated as outcome. In asymptomatic general Korean population, cardiovascular event was found in 1.3 % during median follow up period of 48 months. Various multivariate analyses including C-reactive protein, Framingham risk score (FRS), coronary artery calcium score and degree of coronary artery stenosis showed that FRS and degree of coronary artery stenosis were independent parameters for future adverse cardiovascular events in asymptomatic population (OR 1.068, 95 % CI 1.023–1.114, p = 0.003 for FRS, OR 1.041, 95 % CI 1.031–1.051, p < 0.001 for stenosis). The C-statistics of FRS, degree of stenosis and FRS with degree of stenosis were 0.72 (95 % CI 0.64–0.80), 0.80 (95 % CI 0.72–0.88) and 0.83 (95 % CI 0.75–0.91), respectively. Among the clinical parameters, biomarkers and imaging parameters of cardiovascular disease, both FRS and degree of coronary artery stenosis are independent parameters to predict adverse outcome in asymptomatic population.