Framingham risk score in predicting increased carotid intima-media thickness on ultrasound: identifying patients with subclinical atherosclerosis at high risk

BACKGROUND: Tools to identify patients at high risk for subclinical atherosclerosis (subAS) are lacking. We evaluated the Framingham risk score (FRS) for identifying high-risk subAS patients. METHODS: We enrolled 68 subAS patients and 150 healthy controls. Carotid intima-media thickness (cIMT) was measured via ultrasound in both common carotid arteries, and FRS was calculated. RESULTS: The FRS was low (median, 3.98%). Mean cIMTs for both long and short axes in subAS patients were higher than in healthy individuals (𝑃 < 0.001). In subAS patients, FRS significantly correlated with increased cIMT in long (high-risk OR = 11.61, 95% CI = 2.66–65.95) and short (high-risk OR = 7.11, 95% CI = 1.73–37.79) axes. FRS predicted increased cIMT in long (AUC = 0.713) and short (AUC = 0.673) axes in subAS patients, but not in healthy controls (𝑃 > 0.05). CONCLUSIONS: FRS is associated with high-risk subAS patients, but complementary noninvasive imaging data are needed.