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American Heart Association

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Final ID: MDP1574

Subclinical Coronary Plaque and Atherosclerotic Cardiovascular Disease Events among Overweight Men and Women: A Multi-Cohort Study

Abstract Body (Do not enter title and authors here): Introduction: The population of men and women who are overweight (defined as a BMI 25-29.9 kg/m2) continues to grow at fast pace. The prevalence and prognostic implications of a high coronary artery calcium (CAC) score in this group are poorly defined.

Aims: Using a multiethnic cohort of men and women, we compared the ASCVD event-risk at follow up in normal weight, overweight, and obese individuals, overall and further stratified by CAC scores.

Methods: Individual-level pooled analysis of participants from MESA, JHS, HNR, and FHS free of ASCVD at baseline and in whom CAC and BMI data were available. Participants with BMI <18.5 kg/m2 were excluded. CAC was categorized as =0, 1-99, and ≥100 Agatston Units. The primary outcome was ASCVD events during follow-up, comprising fatal and non-fatal coronary heart disease and stroke events.

Results: A total of 14,740 participants were included. The BMI was distributed as follows: BMI <25 kg/m2: 27.4%, BMI 25-29.9 kg/m2: 40.0%, BMI 30-34.9 kg/m2: 20.8%, BMI >=35 kg/m2: 11.8%. Among overweight participants, 52% had CAC>0, and 22% had CAC≥100 (17% prevalence among individuals with normal weight). The distribution of CAC by BMI categories is presented in the Figure. The incidence of ASCVD events among overweight participants was: 3.8 per 1000 person-years for those with CAC=0, 8.1 for CAC>0 - <=99, and 20.7 for CAC≥100. In regression analyses, compared to BMI 18.5-25 kg/m2 individuals (reference group), the adjusted HR of ASCVD events for overweight participants with CAC≥100 was higher than that for unselected obese participants (Figure). A sub-analysis restricted to participants free of prediabetes and diabetes yielded similar trends, with the combination overweight+high CAC score being associated with a higher ASCVD risk than those with obesity.

Conclusions: The ASCVD risk of overweight people with CAC≥100 is higher than that observed among individuals with BMI≥30 kg/m2. Overweight individuals with high CAC scores comprise relatively frequent and high-risk group, which may benefit from systematic detection and aggressive risk-reduction interventions.
  • Tizon-marcos, Helena  ( Hospital del Mar-IMIM , Barcelona , Spain )
  • Stang, Andreas  ( University Hospital Essen , Essen , Germany )
  • Joeckel, Karl-heinz  ( University Hospital Essen , Essen , Germany )
  • Lehmann, Nils  ( University Hospital Essen , Essen , Germany )
  • Schramm, Sara  ( University Hospital Essen , Essen , Germany )
  • Schmidt, Boerge  ( University Hospital Essen , Essen , Germany )
  • Poirier, Paul  ( QUEBEC HEART AND LUNG INSTITUTE , Quebec , Quebec , Canada )
  • Cainzos Achirica, Miguel  ( Hospital del Mar , Houston , Spain )
  • Al Rifai, Mahmoud  ( Houston Methodist , Houston , Texas , United States )
  • Pappalettere, Carolina  ( Hospital del Mar-IMIM , Barcelona , Spain )
  • Blaha, Michael  ( JOHNS HOPKINS HOSPITAL , Baltimore , Maryland , United States )
  • Marrugat, Jaume  ( IMIM, Barcelona , Barcelona , Spain )
  • Castaner, Olga  ( IMIM, Barcelona , Barcelona , Spain )
  • Nasir, Khurram  ( Houston Methodist , Houston , Texas , United States )
  • Al-mallah, Mouaz  ( Houston Methodist , Houston , Texas , United States )
  • Erbel, Raimund  ( University Hospital Essen , Essen , Germany )
  • Author Disclosures:
    Helena Tizon-Marcos: DO NOT have relevant financial relationships | Andreas Stang: DO NOT have relevant financial relationships | Karl-Heinz Joeckel: DO NOT have relevant financial relationships | Nils Lehmann: No Answer | Sara Schramm: DO NOT have relevant financial relationships | Boerge Schmidt: No Answer | Paul Poirier: DO NOT have relevant financial relationships | Miguel Cainzos Achirica: No Answer | Mahmoud Al Rifai: DO NOT have relevant financial relationships | Carolina Pappalettere: No Answer | Michael Blaha: DO have relevant financial relationships ; Research Funding (PI or named investigator):Bayer:Active (exists now) ; Advisor:New Amsterdam:Expected (by end of conference) ; Advisor:Vectura:Past (completed) ; Advisor:Agepha:Active (exists now) ; Advisor:Astra Zeneca:Past (completed) ; Advisor:Eli Lilly:Active (exists now) ; Advisor:Boehringer Ingelheim:Active (exists now) ; Advisor:Roche:Past (completed) ; Advisor:Merck:Past (completed) ; Advisor:Bayer:Active (exists now) ; Advisor:Novartis:Active (exists now) ; Advisor:Novo Nordisk:Active (exists now) ; Researcher:Amgen:Past (completed) | Jaume Marrugat: No Answer | Olga Castaner: No Answer | Khurram Nasir: DO NOT have relevant financial relationships | Mouaz Al-Mallah: No Answer | Raimund Erbel: No Answer
Meeting Info:

Scientific Sessions 2024

2024

Chicago, Illinois

Session Info:

Prediction in Cardiometabolic Disease

Monday, 11/18/2024 , 12:50PM - 02:15PM

Moderated Digital Poster Session

More abstracts from these authors:
Coronary Artery Calcium Predicts Cardiovascular Events in Individuals with Controlled Atherosclerotic Risk Factors: A Multi-Cohort Study

Mousavi Idine, Schramm Sara, Schmidt Boerge, Al-mallah Mouaz, Cainzos Miguel, Ballantyne Christie, Nambi Vijay, Al Rifai Mahmoud, Blaha Michael, Erbel Raimund, Nasir Khurram, Virani Salim, Blumenthal Roger, Mcevoy John, Stang Andreas

Association of Depression and Anxiety with Coronary Plaque: The Miami Heart Study (MiHeart)

Bafna Tanvi, Blaha Michael, Dzaye Omar, Dardari Zeina, Cainzos Miguel, Blankstein Ron, Feldman Theodore, Budoff Matthew, Fialkow Jonathan, Nasir Khurram

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