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Subclinical atherosclerosis is associated with increased SCORE risk values in a population without cardiovascular disease

Session Poster Session III - Friday 08:30 - 12:30

Speaker Ovidiu Mitu

Event : ESC Preventive Cardiology (Formerly EuroPrevent) 2015

  • Topic : preventive cardiology
  • Sub-topic : Risk Factors and Prevention
  • Session type : Poster Session

Authors : O Mitu (Iasi,RO), F Mitu (Iasi,RO), M Roca (Iasi,RO), I-C Roca (Iasi,RO), M-M Leon (Iasi,RO), M Mitu (Iasi,RO), L Arhire (Iasi,RO), O Nita (Iasi,RO), L Mihalache (Iasi,RO), M Graur (Iasi,RO)

Authors:
O Mitu1 , F Mitu1 , M Roca1 , I-C Roca1 , M-M Leon1 , M Mitu1 , L Arhire1 , O Nita1 , L Mihalache1 , M Graur1 , 1University of Medicine and Pharmacy "Gr. T. Popa" - Iasi - Romania ,

Citation:

Purpose: Cardiovascular diseases (CVD) represent the main cause of mortality worldwide. European guidelines recommend the use of SCORE risk chart in asymptomatic subjects with no evidence of CVD. However, the risk charts have their limitations particularly in the moderate risk population for assessing the real CV risk. The aim of our study was to determine whether subclinical atherosclerosis is associated with increased SCORE values in a population free of CVD.
Methods: In the current prospective study, we have randomized from an urban general population 71 subjects free of any CVD and medical treatment, aged 35-75. All participants underwent the following: CV risk factor assessment, systolic and diastolic blood pressure (SBP, DBP) measurement and CV risk evaluation by applying SCORE chart. Subclinical atherosclerosis was determined by multiple investigations: left ventricular mass index (LVMI) and ejection fraction (EF) by echocardiography, intima-media thickness (IMT) and carotid plaques by carotid ultrasound, ankle-brachial index (ABI) and aortic stiffness parameters (pulse wave velocity – PWV, augmentation indexes, central SBP). All measurements were performed by the same operator with the same device. The study was approved by the University ethics committee and all participants signed an informed consent. The statistical analysis was performed in SPSS v 16.0.
Results: Mean age of participants was 49.93±9.4 years, with 34% male gender. Mean SBP and DBP were 125.93±16.0, respectively 79.85±12.26 mmHg. IMT was 0.83±0.12 mm while PWV was 7.99±1.65 m/s. The SCORE risk in this population was moderate: 2.34±1.94. Among the markers of subclinical atherosclerosis, an increased SCORE risk was positively associated with higher IMT and presence of carotid plaques (r=0.47, p<0.001; and r=0.70, p<0.001), SBP and DBP (r=0.41, p=0.001; and r=0.35, p=0.002) and LVMI (r=0.25, p=0.03). Regarding aortic stiffness markers, PWV and aortic SBP were directly correlated with high SCORE risk (r=0.29, p=0.01; and r=0.4, p=0.001). No positive correlations were found between increased SCORE risk and lower EF or ABI.
Conclusions: High SCORE values are strongly associated with markers of subclinical atherosclerosis such as increased IMT, carotid plaques, left ventricular hypertrophy, PWV or central SBP. The use of these methods can modify the risk assessed by SCORE chart if subclinical atherosclerosis is evidenced, especially in asymptomatic population with moderate risk.

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