The role of coronary CT angiography and person"s lifestyle habits in assessment of risk for primer protection from cardiovascular diseases
Authors: Uzumcu H , Ozpelit E , Ozpelit M , Ercan E , Sahinoglu B , Yilmaz M 
Published: February 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Prevention of atherosclerotic coronary artery disease (CAD), is primarily based on risk assesment. SCORE risk model is the most widely used risk assesment tool which is a comprehensive model of classical risk factors for CAD . However this model does not include several important risk factors such as socioeconomic level, education status, social support , sedantary life style, systemic inflammation and etc.. SCORE model also does not have any component about imaging findings. Actually high Agatston score, which measures coronary artery calcium (CAC) in cardiac computed tomography angiography (CCTA) is an important risk estimator for CAD.

Aim
The aim of this study is to investigate the importance of CCTA findings together with sociocultural and lifestyle characteristics of individuals on top of SCORE risk assesment

Methods
565 patients who applied to the Izmir Medical Park Hospital cardiology outpatient clinic between 15.01.2019-20.01.2020 and underwent CCTA were screened. Patients with known CAD were excluded,497 people were included in the study.Cardiovascular risk factors, socioeconomic and lifestyle characteristics of the person were learned and SCORE risk calculated. Agatston CAC score (CACS), presence of hepatosteatosis, paracardial adipose tissue thickness (PATT) measured in CCTA.Data of individuals were analyzed in terms of presence of Agatston CACS. Parameters that were significant in univariate analysis were included in multivariate analysis. Independent predictors of atherosclerosis were investigated.

Results
Patients were divided into 2 groups according to CAC score: group 1 with an CCS = 0 and group 2 as CCS &gt; 0 . Among several lifestyle and sociocultural characteristics assesed, only having an active working life was found to be significantly associated with CCS = 0 (table 1) However in multivariate analysis, significance was lost for active working ; the only significant predictors of CCS = 0 were SCORE value of &lt;5 and PATT &lt; 5mm. (table 2) The PATT value was a more powerful predictor of atherosclerosis compared to the all other well known metabolic parameters such as BMI, blood glucose and lipid levels

Conclusion
Although SCORE risk model does not include components about lifestyle characteristics of individuals and imaging findings , it was the most powerful estimator of presence of atherosclerosis. No single lifestyle characteristics was able to predict CAD independently. However the PATT which is a marker of visseral obesity with inflamatory roles on heart and coronary arteries, was found to be an independent predictor of atherosclerosis on top of SCORE risk. So we think that The measurement of PATT can be useful to predict an individual"s risk of atherosclerosis. We can use it in our routine practice to make the risk assessment of people more effective. Abstract Figure. Independent Predictors of Being Agatston Abstract Figure. Independent Predictors of Being Agatsto2