Relationship between cardiovascular global risk in primary and secondary prevention and carotid atherosclerosis

Clinical and epidemiological studies have provided mathematical algorithms based on vascular risk factors useful to estimate the 10 years global risk of vascular events. Although derived by selected populations, these algorithms are often used in clinical practice to estimate the individual risk of patients with quite different characteristics. In the present study we have investigated whether the Framingham Risk Score (FRS) and the GISSI Risk Score (GRS), two algorithms useful to calculate the individual global risk in primary and secondary prevention, are associated with carotid artery intima media thickness (IMT) and IMT-progression, two parameters widely accepted as indexes of carotid and even coronary atherosclerosis. 1205 asymptomatic and 262 symptomatic patients have been recruited to investigate the association with cross-sectional IMT. 312 asymptomatic and 92 in secondary prevention patients with at least 5 years of follow-up have been recruited to investigate how FRS and GRS affect the IMT-progression. While cross-sectional IMT significantly increases with the raising of quartiles of global risk of patients in both primary and secondary prevention (both p<0.0001; 4th vs 1st quartiles), IMT-progression is not affected by the individual global risk both in primary (FRS) and in secondary prevention (GRS). The positive association between FRS, GRS and IMT suggests that both these algorithms reflect the individual atherosclerotic pattern also in an Italian population of patients attending a Lipid Clinic.