3139Social determinants but not psychological factors improve prediction of subclinical atherosclerosis in patients with a family history of premature coronary artery disease

Background: CT derived coronary calcium score (CCS) identifies subclinical atherosclerosis and is a powerful predictor of risk. Positive family history predisposes to coronary artery disease (CAD) likely through genetic, environmental and heritability of traditional risk factors. Traditional risk factors are modestly associated with CCS, with other factors accounting for differences between estimated risk and CCS. Psychosocial risk factors which are not included in most CAD risk scores but are associated with incident cardiovascular disease (CVD), may explain this discordance. Aims: To defined whether addition of psychosocial risk factors improves the association between risk scores and CCS. Methods: In this prospective multicentre study of 762 asymptomatic, statin-naïve individuals from ages 40–70 years with a family history of premature coronary artery disease, CCS was performed using standard techniques. Framingham risk score (FRS) was calculated from clinical variables. Information was gathered on education, socioeconomic index (SEIFA), anxiety (GAD7 score), depression (PHQ9 score) and living alone. Area under the curve was used to compare predictability of CVD risk tools to positive CCS score and determine if addition of psychosocial risk factors improved discrimination.