Abstract 18267: Coronary Risk Factors and Prevalence and Severity of Coronary Atherosclerosis in the Young

Abstract

Purpose. We examined the relationship between coronary risk factors (RF) and prevalence and severity of coronary atherosclerosis in young individuals undergoing coronary CT angiography (CCTA). Methods. Of 27125 patients undergoing CCTA, 1635 young (50%stenosis), and presences of calcified plaque (CP) and non-calcified plaque (NCP). Results. Among 1635 subjects (70% men, age 38±6 years), 6% had diabetes (DM), 31% had hypertension (HTN), 37% had dyslipidemia (CHOL), 21% had smoking (SM) and 33% had family history (FH) of CAD. Among all young individuals, any CAD, obs CAD, CP and NCP were observed in 19%, 4%, 5%, and 8%, respectively. Compared to women, men demonstrated higher rates of any CAD (21% vs 12% P<0.001), CP (6% vs 3% P=0.01), and NCP (9% vs 5% P=0.008), although no difference was observed for rates of obs CAD (5% vs. 4% P=NS). Any CAD, obs CAD, and NCP were higher for young individuals with DM, HTN, CHOL, SM or FH of CAD; while only DM and CHOL were associated with CP (Table). In multivariable analysis adjusting for sex and RFs, male sex was the strongest predictor for any CAD (Odds Ratio [OR] 1.95, 95% Confidence Interval [CI] 1.43-2.66, P<0.001), CP (OR 1.46, 95%CI 1.08-1.98, P=0.014) and NCP (OR 1.33, 95%CI 1.06-1.67, P=0.014); while FH of CAD was the strongest predictor for obs CAD (OR 2.71, 95% CI 1.65-4.45, P3 RFs manifesting a significant increase in any CAD (P<0.001 for trend); obs CAD (P<0.001 for trend); NCP (P<0.001 for trend) and CP (P=0.008 for trend). Conclusions. CAD is present in 1 in 5 young individuals, with sex and coronary RFs associated with increasing presence and severity of CAD.