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Coronary Artery Calcification score can predict Cardiovascular Disease in asymptomatic patients with Metabolic Syndrome
Session:
Posters - J. Preventive Cardiology
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:
Posters
FP Number:
---
Authors:
Margarida Temtem; Marco Gomes Serrão; Isabel Mendonça; Marina Santos; Flávio Mendonça; Adriano Sousa; Ana Célia Sousa; Mariana Rodrigues; Sónia Freitas; Eva Henriques; 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>Background: </strong>Metabolic Syndrome (MetS) is a clinical condition composed of metabolic and cardiovascular risk factors, such as abdominal obesity, hyperglycemia, dyslipidemia and hypertension. Many<span style="color:black"><span style="background-color:white"> patients with MetS suffer major adverse cardiovascular events (MACE) that are not adequately identified by traditional risk assessment, suggesting the need for early detection of subclinical coronary heart disease to identify those at high risk. Coronary artery calcification (CAC) screening has added utility in categorizing patients with low, intermediate and high cardiovascular risk.</span></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>Purpose: </strong>E<span style="color:black"><span style="background-color:white">valuate the prognostic role of CAC score in </span></span>cardiovascular events risk prediction<span style="color:black"><span style="background-color:white"> in an asymptomatic population with metabolic syndrome</span></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>Methods:</strong> A total of 1122 asymptomatic individuals without known coronary heart disease, enrolled from GENEMACOR study, were followed for a mean of 5.3±3.4 years for the primary endpoint of all cardiovascular events. All persons were referred for computed tomography for the CAC scoring assessment. According to the Hoff's nomogram, 3 categories were created: low CAC (0≤CAC<100 or P<50); moderate CAC (100≤CAC<400 or P50-75) and high or severe CAC (CAC≥400 or P>75). In a subgroup of 507 individuals with MetS and 615 controls, CAC values were compared by T-student and association of CAC severity with events occurrence was evaluated. Finally, a logistic regression model adjusted for CAC severity was performed in patients with MetS. </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>Results:</strong> Among our population, the extent of CAC differs significantly between men and women in the same age group. Patients with MetS (23.2%, n=115) had higher CAC scores than controls (219.0±486.0 vs 115.8±370.8, p<0.0001). In this cohort, with higher CAC scores, 46.7% vs 22.5% had MACE (p=0.049) during the follow-up. The logistic regression analysis revealed that CAC≥400 is a MACE predictor (OR=4.326, CI 95% 1.241-15.080, p=0.021) in patients with MetS.</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>Conclusion:</strong> Our results point to the importance of the inclusion of CAC screening in patients with MetS <span style="color:black"><span style="background-color:white">to further stratify those patients that, despite tight control of cardiovascular risk factors, may benefit from more intensive therapies. This tool </span></span>is a useful and straightforward method that <span style="color:black"><span style="background-color:white">could have a significant impact on </span></span>the prediction of future cardiovascular disease in asymptomatic patients with MetS.</span></span></span></p>
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