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Is there a different impact of traditional risk factors on coronary calcium score, in an asymptomatic population?
Session:
CO 09 - Cardiologia Preventiva
Speaker:
Margarida Temtem
Congress:
CPC 2021
Topic:
J. Preventive Cardiology
Theme:
28. Risk Factors and Prevention
Subtheme:
28.2 Risk Factors and Prevention – Cardiovascular Risk Assessment
Session Type:
Comunicações Orais
FP Number:
---
Authors:
Margarida Temtem; Marco Gomes Serrão; Isabel Mendonça; Marina Santos; Flávio Mendonça; Adriano Sousa; Ana Célia Sousa; Sónia Freitas; Eva Henriques; Mariana Rodrigues; Sofia Borges; Graça Guerra; António Drumond; Roberto Palma Dos Reis
Abstract
<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong><span style="font-size:10pt">Background:</span></strong><span style="font-size:10pt"> The coronary calcium score has been increasingly used to stratify and predict cardiovascular risk, particularly in low and intermediate-risk persons. Understanding which determinants have more impact on coronary calcium score level, could lead to the development of new stricter preventive measures for reducing coronary artery calcification (CAC) and, consequently, cardiovascular risk. </span></span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong><span style="font-size:10pt">Purpose: </span></strong><span style="font-size:10pt">Our study aimed to investigate the impact of the traditional risk factors (TRFs) on the CAC score level and if there is a different association between this TRFs and CAC score degrees, in an asymptomatic population.</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong><span style="font-size:10pt">Methods:</span></strong> <span style="font-size:10pt">The study cohort comprised 1122 consecutive asymptomatic individuals without known coronary artery disease (CAD) belonging to the healthy controls of GENEMACOR study,</span><span style="font-size:10pt"> referred for computed tomography for CAC assessment. The traditional risk factors considered were (1) current cigarette smoking, (2) dyslipidemia, (3) diabetes mellitus, (4) hypertension and (5) family history of coronary artery disease. According to the Hoff´s nomogram, 3 categories were created: low CAC (0≤CAC<100 and P<50); moderate CAC (100≤CAC<400 or P50-75) and high or severe CAC (CAC≥400 or P>75). We evaluated the association of the different TRFs with these levels of CAC score (Chi-square test). Finally, we performed a logistic regression model adjusted for all significant TRFs selected in the bivariate analyses.</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong><span style="font-size:10pt">Results: </span></strong><span style="font-size:10pt">Smoking was significantly associated with high levels of CAC score, 28.4% vs 21.7%; p=0.038 as well as hypertension, 58.8% vs 45.6%; p=0.001, type 2 diabetes 21.1% vs 9.6%; p<0.0001, dyslipidemia, 73.0% vs 66.1%; p=0.057. Family history did not show a significant association with CAC (p=0.717). Then, we constructed a logistic regression model adjusted the significant risk factors in previous analysis. The final multivariate analysis, selected as independent predictors of high CAC: Type 2 diabetes (OR=2.309; 95%CI 1.533-3.479; p<0.0001), hypertension (OR=1.627; 95%CI 1.185-2.233; p=0.003) and smoking (OR=1.565; 95%CI 1.102-2.222; p=0.012).</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong><span style="font-size:10pt">Conclusions:</span></strong><span style="font-size:10pt"> In this study, well-known and modifiable traditional risk factors are associated with high calcium score levels. However, diabetes and hypertension seem to be preferentially associated with higher CAC scores, while tobacco, although it has a significant association, seems to be not so strong as diabetes and hypertension. This concept may mean that smoking has its primary role in plaque instability and not so much in the growing and calcification of plaques.</span></span></span></span></p>
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