Presented by: Kui-Kai Lau, Yap-Hang Chan, Kai-Hang Yiu, MBBS, Sidney Tam, MD, Sheung-Wai Li, MBBS, Chu-Pak Lau, MD, Hung-Fat Tse, MD,PhD.

1. Incremental Predictive Value of Vascular Assessments Combined with the Framingham Risk Score for Prediction of Coronary Events in Subjects of Low Intermediate Risk Kui-Kai Lau, 1 Yap-Hang Chan, 1 Kai-Hang Yiu, MBBS, 1 Sidney Tam, MD, 2 Sheung-Wai Li, MBBS, 3 Chu-Pak Lau, MD, 1 Hung-Fat Tse, MD,PhD. 1 1 Cardiology Division, The University of Hong Kong, 2 Department of Clinical Biochemistry Unit, Queen Mary Hospital, and 3 Department of Medicine, Tung Wah Hospital, Hong Kong, China.

9. Clinical Characteristics of Study Population 1.0 35 (100) 70 (100) Males, n (%) <0.001 1 (3) 55 (79) Lipid lowering therapy, n (%) <0.001 10 (29) 62 (89) Anti-hypertensives, n (%) 0.10 1 (3) 9 (13) Family history of cardiovascular disease, n (%) 0.27 15 (43) 38 (54) Smoking, n (%) 1.0 0 (0) 0 (0) Diabetes, n (%) 0.002 19 (54) 58 (83) Hypercholesterolemia, n (%) 0.001 9 (26) 42 (60) Hypertension, n (%) 0.12 24.0  3.1 25.1  3.3 Body-Mass Index, kg/m 2 0.11 59.5  8.9 62.4  8.5 Age, years P Value Controls (N=35) CAD (N=70) Characteristic

10. Vascular Assessments of Study Population 0.008 14 (40) 47 (67) Carotid plaque (%) 0.32 0.96  0.14 1.01  0.28 mmIMT (mm) 0.003 5.18  2.69 3.56  2.41 FMD (%) P Value Controls (N=35) CAD (N=70)

11. Correlations between FRS and Vascular Markers r= 0.314, p=0.001 r= -0.246, p=0.016 r= -0.226, p=0.026

12. Diagnostic Values of FRS & Vascular Markers According to Specified Cut-off Values 54.5 80.7 68.6 69.7 - 0.000 0.69 FRS + mmIMT  1.05 47.3 80.9 74.3 56.7  2.50 0.007 0.66 FRS 83.3 82.3 81.2 81.4 80 .0 77.0 79.1 PPV 71.4 68.6 62.9 68.6 82.9 60.0 60.0 SP 60.0 81.5  4.75 0.001 0.70 FMD, % 66.7 81.0 - 0.000 0.75 FRS + FMD  4.75 + Carotid Plaque 61.0 75.8 - 0.000 0.73 FRS + Carotid plaque + mmIMT  1.05 66.7 83.6 - 0.000 0.72 FRS + Carotid Plaque 61.5 76.2 - 0.000 0.78 FRS + FMD  4.75 39.2 34.8  1.05 0.492 0.54 mm IMT, mm 47.7 67.1 - 0.033 0.64 Carotid plaque NPV SN Cut-off values P Value AUC Marker

13. Incremental Benefit of Vascular Markers in Addition to FRS for Coronary Risk Prediction FRS, AUC=0.66 FRS + Carotid plaque, AUC=0.72 (P=0.008 vs. FRS) FRS + FMD ≤4.75%, AUC=0.78 (P=0.007 vs. FRS) 1-Specificity Sensitivity 0.0 0.2 0.4 0.6 0.8 1.0 0.0 0.2 0.4 0.6 0.8 1.0

14. Univariate and Multivariate Predictors of an Acute Coronary Event 0.001 4.33 (1.77-10.62) Hypertension 0.003 4.80 (1.67-13.65) 0.000 5.28 (2.20-12.68) Hypercholesterolemia 0.27 1.58 (0.70-3.59) Smoking 0.009 3.07 (1.32-7.10) Carotid plaque 0.066 2.58 (0.94-7.07) mmIMT  1.05mm <0.001 7.97 (2.69-23.59) <0.001 6.63 (2.64-16.66) FMD  4.75% 0.034 1.45 (1.03-2.05) 0.006 1.50 (1.13-2.00) FRS P Value OR (95% CI) P Value OR (95% CI) Multivariable Univariable Risk Variables