Systematic Coronary Risk Evaluation estimated risk and prevalent subclinical atherosclerosis in coronary and carotid arteries: A population-based cohort analysis from the Swedish Cardiopulmonary Bioimage Study

Research output: Contribution to journalArticle


BACKGROUND: It is not clear if the European Systematic Coronary Risk Evaluation algorithm is useful for identifying prevalent subclinical atherosclerosis in a population of apparently healthy individuals. Our aim was to explore the association between the risk estimates from Systematic Coronary Risk Evaluation and prevalent subclinical atherosclerosis.

DESIGN: The design of this study was as a cross-sectional analysis from a population-based study cohort.

METHODS: From the general population, the Swedish Cardiopulmonary Bioimage Study randomly invited individuals aged 50-64 years and enrolled 13,411 participants mean age 57 (standard deviation 4.3) years; 46% males between November 2013-December 2016. Associations between Systematic Coronary Risk Evaluation risk estimates and coronary artery calcification and plaques in the carotid arteries by using imaging data from a computed tomography of the heart and ultrasonography of the carotid arteries were examined.

RESULTS: Coronary calcification was present in 39.5% and carotid plaque in 56.0%. In men, coronary artery calcium score >0 ranged from 40.7-65.9% and presence of carotid plaques from 54.5% to 72.8% in the age group 50-54 and 60-65 years, respectively. In women, the corresponding difference was from 17.1-38.9% and from 41.0-58.4%. A doubling of Systematic Coronary Risk Evaluation was associated with an increased probability to have coronary artery calcium score >0 (odds ratio: 2.18 (95% confidence interval 2.07-2.30)) and to have >1 carotid plaques (1.67 (1.61-1.74)).

CONCLUSION: Systematic Coronary Risk Evaluation estimated risk is associated with prevalent subclinical atherosclerosis in two major vascular beds in a general population sample without established cardiovascular disease or diabetes mellitus. Thus, the Systematic Coronary Risk Evaluation risk chart may be of use for estimating the risk of subclinical atherosclerosis.


  • Carl J Östgren
  • Stefan Söderberg
  • Karin Festin
  • Oskar Angerås
  • Göran Bergström
  • Anders Blomberg
  • John Brandberg
  • Kerstin Cederlund
  • Mats Eliasson
  • Erika Fagman
  • Emil Hagström
  • Lars Lind
  • Maria Mannila
  • Ulf Nilsson
  • Jonas Oldgren
  • Anders Persson
  • Jonas Persson
  • Annika Rosengren
  • Johan Sundström
  • Eva Swahn
  • Jan E Engvall
  • Tomas Jernberg
External organisations
  • Umeå University
  • Karolinska Institutet
  • Uppsala University
  • Karolinska University Hospital
  • Sahlgrenska University Hospital
  • Linköping University
  • University of Gothenburg
  • Skåne University Hospital
  • University of New South Wales
  • Danderyd Hospital
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Cardiac and Cardiovascular Systems
Original languageEnglish
Pages (from-to)1-12
JournalEuropean Journal of Preventive Cardiology
Publication statusE-pub ahead of print - 2020 Mar 3
Publication categoryResearch