Abstract 17076: The Relationship Between Impaired Microvascular Function, Cardiovascular Risk Profile and Subclinical Atherosclerotic Burden in a Swedish Middle-Aged Cohort

Abstract

Introduction: Microvascular function is associated with cardiovascular risk factors and deteriorates in individuals with cardiovascular disease. Hypothesis: The aim of this study was to investigate the relationship between microvascular function, cardiovascular risk profile and subclinical atherosclerotic burden. Methods: The study enrolled 3809 randomly selected individuals, 50-65 years old, participating in the population-based observational cross-sectional Swedish CArdioPulmonary bioImage Study (SCAPIS). Microvascular function was measured in forearm skin using an arterial occlusion and release protocol determining the peak blood oxygen saturation, OxyP. Cardiovascular risk was calculated using the updated Systematic Coronary Risk Evaluation (SCORE2; 10-year risk of fatal and non-fatal CVD events). OxyP was compared with Coronary artery calcification score (CACS) and plaques in the carotid arteries. Results: Individuals with OxyP values in the lowest quartile (Q1; impaired microvascular function), had a mean SCORE2 of 5.8% compared to 3.8% in those with the highest values of OxyP (Q4), a relative risk increase of 53%. In the low-risk SCORE2 level (<5% risk), 19.0% of the individuals have impaired microvascular function as compared to 48.1% in the high-risk SCORE2 level (>10% risk). OxyP was lower in individuals with coronary artery calcification (CACS>0) and those with both carotid plaque and CACS>0, as compared to individuals without subclinical atherosclerotic burden (CACS=0 and no carotid plaque; 87.5 ±5.6 % and 86.9 ±6.0 % vs 88.6 ± 5.8 %, p < 0.01). Conclusion: In a population without cardiovascular disease or diabetes mellitus, impaired microvascular function is associated with higher SCORE2 risk and CACS>0. Hence, assessment of microvascular function may be a useful tool for accurate cardiovascular risk prediction, in addition to imaging assessment of atherosclerosis in the coronary and carotid arteries.