Predictive Values of the Ideal Cardiovascular Health and the Fuster-BEWAT Scores for Detecting Subclinical Atherosclerosis in Healthy Individuals

Abstract

Background: The Ideal Cardiovascular Health Score (ICHS) has been validated for predicting CV event risk. The Fuster-BEWAT Score (FBS) is simpler as it does not use laboratory parameters (cholesterol and fasting glucose). The predictive value of these scores to detect the extent of subclinical atherosclerosis (SA) in healthy individuals has not been validated or compared.

Methods: ICHS and FBS were calculated in 4047 healthy workers (45.8 years, 36.9% women) participating in the CNIC-PESA study. The extent of SA was quantified in 6 arterial sites: carotids, ilio-femorals and aorta by 2-dimensional ultrasound, and coronary calcification by computed tomography. Generalized SA was defined as ≥4 affected vascular territories.

Results: There was a strong inverse association between ICHS and FBS values with the extent of SA (Figure). By ordinal regression models, the odds ratio for a more generalized (or extensive) SA category was 0.33 (95%CI, 0.25-0.42) and 0.38 (0.31-0.48) among subjects with ideal ICHS and FBS respectively, with poorer score values as reference. Discrimination for generalized SA was identical for ICHS (c statistic 0.77 [95%CI, 0.75-0.79]) as for FBS (c=0.77 [0.75-0.79]).

Conclusions: Both, ICHS and FBS show a good and comparable predictive value to detect the extent of SA in healthy individuals.