Women with coronary calcium found at risk for heart attack

A study's findings offer further evidence that the Framingham risk assessment tool needs revision, but it's still unclear how the test may fit in.

By Victoria Stagg Elliott, AMNews staff. Jan. 14, 2008.

Women who have scan-detected coronary artery calcium might have a greater risk of heart and vascular trouble than their Framingham risk scores indicate, according to a study published in the Dec. 10/24, 2007, Archives of Internal Medicine.

"Framingham is our best risk score right now, but this study challenges us to do a better job of assessing risk in women and identifying who is going to have an event," said Susan G. Lakoski, MD, lead author and a fellow at North Carolina's Wake Forest University School of Medicine.

Researchers analyzed data on 3,601 women followed for nearly four years. Approximately 90% were identified by Framingham as not having much of a chance of developing heart problems. But of this group, 32% had calcium deposits in their coronary arteries, which actually increased the odds of developing coronary heart disease during the study period to 6.5-to-1.

The paper is the most recent to suggest that Framingham does not work as well for women as it does for men.

The vast majority of females are classified as low risk for heart disease according to Framingham. This categorization means they are not candidates for aggressive primary prevention despite the fact that the majority will die of cardiovascular-related conditions. And those behind Framingham agree it may be time for a revision, to take into account not just new technology but more traditional factors that can impact women.