Effectiveness of Framingham and ASCVD Risk Scores in Predicting Coronary Artery Disease - A Comparative Study with Syntax Score.

OBJECTIVES: Primary objective was to determine an association between Atherosclerotic Cardiovascular Disease (ASCVD) and Framingham (FRS) risk scores with Syntax score(SS). Secondary objective was to determine sensitivity, specificity and discriminative ability of FRS and ASCVD risk scores in detecting Coronary Artery Disease (CAD) and predicting its severity.

MATERIALS AND METHODS: This is a cross-sectional study carried out in the Comprehensive Health Clinic of Amrita Institute of Medical Sciences, Kochi, Kerala. Patients voluntarily visiting the clinic for a health check-up were referred to Cardiology based on a positive treadmill test result where they underwent a coronary angiogram. Secondary data on patients' demographics, prior history of cardiovascular diseases, investigations and interventional procedures was collected from the hospital registry. The risk scores were calculated using the data through online calculators. Analysis was carried out using SPSS.

RESULTS: Chi-square analysis showed significant association between FRS and SS. Both FRS and ASCVD risk scores have good sensitivity for CAD while having good specificity for patients with high Syntax score (SS≥33). ROC curve showed that ASCVD risk score has a higher positive likelihood ratio than FRS for predicting CAD and high Syntax Score Patients.

CONCLUSION: The study concludes that FRS and ASCVD risk scores are effective risk predicting models for CAD. FRS is a more sensitive risk score than ASCVD risk score in predicting CAD whereas ASCVD risk score has a higher ability to differentiate patients with CAD and high Syntax Score than FRS.