Association Between Hearing Loss and Subclinical Coronary Atherosclerosis: An Observational Cohort Study

Objectives: To retrospectively analyze the association between hearing loss and subclinical coronary atherosclerosis. Study design: Retrospective cohort study. Setting: Health promotion center of tertiary academic referral center. Patients: A total of 9286 individuals [mean age, 53.8 ± 8.0 y; men, 6014 (64.8%)] without a history of coronary artery disease (CAD). Intervention: Coronary computed tomographic angiography (CCTA) and audiometry as part of a general medical checkup. Main outcome measures: The presence of subclinical coronary atherosclerosis detected by CCTA (obstructive CAD ≥50% diameter stenosis) and the presence of moderate hearing loss, which exceeded 40 decibels in the better ear. Results: In total, 455 (4.9%) participants had moderate hearing loss. After adjusting for cardiovascular risk factors, no statistically significant differences were observed for any coronary plaque [odds ratio (OR): 1.162, 95% CI: 0.930-1.450; P = 0.186], calcified plaque (OR: 1.097, 95% CI: 0.880-1.367; P = 0.411), noncalcified plaque (OR: 1.150, 95% CI: 0.827-1.599; P = 0.406), or obstructive CAD (OR: 1.065, 95% CI: 0.780-1.456; P = 0.691) between individuals with and without moderate hearing loss. A significant association was observed between participants with moderate hearing loss and mixed plaque (OR: 1.557; 95% CI: 1.089-2.226; P = 0.015). In a propensity score-matched population (n = 860), a significant association was observed between moderate hearing loss and mixed plaque (OR: 1.771, 95% CI: 1.081-2.902; P = 0.023). Conclusions: In asymptomatic individuals, moderate hearing loss was significantly associated with mixed plaque, suggesting poorer cardiac outcomes.