The following is a summary of “Comprehensive Prediction of Subclinical Coronary Atherosclerosis in Subjects Without Traditional Cardiovascular Risk Factors,” published in the July 2023 issue of the Cardiovascular Disease by Park et al.
It is common for asymptomatic individuals with no identified cardiovascular risk factors to exhibit atherosclerosis-related adverse events. The researcher’s objective was to assess the factors that can predict the presence of subclinical coronary atherosclerosis in individuals who do not demonstrate conventional cardiovascular risk factors. Researchers comprehensively evaluated 2,061 individuals who did not reveal any discernible cardiovascular risk factors and willingly underwent coronary computed tomography angiography as a component of their routine general health assessment. The existence of coronary plaques characterizes subclinical atherosclerosis.
Among the cohort of 2,061 individuals, a total of 337 individuals (16.4%) exhibited subclinical atherosclerosis. Medical variables, including age, gender, body mass index (BMI), systolic blood pressure (SBP), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C), exhibited a significant correlation with subclinical coronary atherosclerosis. The subjects were randomly divided into training and validation datasets. In the study cohort, a predictive model was developed using 6 variables with optimal thresholds (age >53 years for men and >55 years for women, gender, BMI >22 kg/m2, SBP >120 mm Hg, HDL-C <55 mg/100 ml, and LDL-C >130 mg/100 ml). The model demonstrated an area under the curve of 0.780 (95% confidence interval 0.751 to 0.809) and a goodness-of-fit P=0.693.
In the validation set, this medical model demonstrated favorable performance (area under the curve 0.792, 95% CI 0.726 to 0.858, goodness-of-fit P = 0.073). In summary, with nonmodifiable risk factors like age and gender, modifiable factors, including BMI, SBP, LDL-C, and HDL-C, can be linked to subclinical coronary atherosclerosis, even within the acceptable range. These findings indicate that implementing more stringent management of body mass index (BMI), blood pressure, and cholesterol levels may be beneficial in preventing subsequent coronary events.