Key result
Concurrent smoking and diabetes linked to ~13.5-fold higher odds of very severe coronary calcification.
Why the study?
Romania ranks as a country with a very high risk of cardiovascular diseases, but data are limited regarding the prevalence of coronary calcium score.
Do conventional cardiovascular risk factors predict the severity of coronary artery calcification in patients undergoing cardiac computed tomography?
Cross-Sectional (n=222)
No
Do conventional cardiovascular risk factors predict the severity of coronary artery calcification in patients undergoing cardiac computed tomography?
Odds Ratio: 13.46 (95% CI 3.27–55.46)
p-value: p=0.001
Multiple concurrent cardiovascular risk factors, particularly the combination of smoking and diabetes, are strongly associated with a highly elevated coronary artery calcium burden.
Should not yet change CAC risk stratification; leaves open synergistic effects in prospective cohorts.
(1) Background: Cardiovascular disease is the leading cause of mortality worldwide; the prevention and early detection of coronary artery disease are of critical importance; and the coronary artery calcium score is a powerful method in the assessment of coronary artery disease. Among European countries, Romania ranks as a country with a very high risk of cardiovascular diseases, but the data are limited in regard to the prevalence of the calcium score. (2) Methods: A retrospective study was conducted to establish the coronary calcium score in a group of patients investigated via cardiac CT and to determine the correlation with the presence of cardiovascular risk factors. (3) Results: According to the Agatston calcium score, 50% of the patients had a positive calcium score. High calcium scores above 400 UA were present in 12.6% of patients. Regarding the association between the presence of cardiovascular risk factors and the levels of coronary artery calcification, a mild level of calcification was associated with age over 50 years (X2 = 3.88, p = 0.04, OR = 3.25; 95% CI 0.94–11.14); a moderate level of calcification with the age of patients over 50 years (X2 = 6.54, p = 0.01, OR = 5.58; 95% CI 1.29–24.16), dyslipidemia (X2 = 7.28, p = 0.007, OR = 3.37; 95% CI 1.34–8.51), and arterial hypertension (X2 = 5.37, p = 0.02, OR = 2.88; 95% CI 1.14–7.27); a severe level of calcification with hypertension (X2 = 4.61, p = 0.03, OR = 7.03; 95% CI 0.90–54.81); and a very severe level of calcification with hypertension (X2 = 4.61, p = 0.03, OR = 7.03; 95% CI 0.90–54.81), smoking (X2 = 8.07, p = 0.004, OR = 4.44; 95% CI 1.47–13.44), and diabetes (X2 = 13.65, p = 0.001, OR = 6.59; 95% CI 2.5–20.18). (4) Conclusion: Half of the patients investigated by using cardiac CT had a calcium score of zero. Predictors for coronary calcium scores in relation to risk factors varied. For the very severe coronary calcification level, the strongest predictor was the presence of smoking and diabetes, which increased the odds for very severe calcification by 13.46 times. Patients who had multiple cardiovascular risk factors, hypertension, diabetes, and smoking were 9.18 times more likely to have very severe calcification.
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Capisizu et al. (2023) conducted a cross-sectional in Suspected or known coronary artery disease (n=222). Concurrent smoking and diabetes vs. Absence of concurrent smoking and diabetes was evaluated on Very severe coronary calcification (>1000 Agatston Units) (OR 13.46, 95% CI 3.27-55.46, p=0.001). The presence of concurrent smoking and diabetes strongly predicted very severe coronary artery calcification, increasing the odds by 13.46 times.
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