Prevalence and clinical associations of subclinical atherosclerosis identified by coronary artery calcium scoring: a cross-sectional study

https://doi.org/10.63923/smhs.2025.32

Abstract

Introduction: One of the main objectives of public politics in Brazil is to reduce cardiac mortality related to coronary arterial diseases (CAD). Considering that a significant proportion of cardiac death occurs in asymptomatic patients, it is very important to identify subgroups of people with the high risk of CAD. The coronary artery calcium (CAC) is a specific marker that accurately identifies the atherosclerotic burden, which is directly proportional to the incidence of cardiovascular events.

Objectives: To evaluate the prevalence of subclinical atherosclerosis defined as altered CAC in patients in a micro-region of Santa Catarina, recognizing the most prevalent risk factors.

Methods: In a cross-sectional study, 547 patients who underwent CAC between January/2016 and December/2021 were included. Statistical analyses were performed using SPSS Software employing Fisher’s exact test or Pearson’s chi-square test. The level of statistical significance was set at p < 0.05 for all analyses. 

Results: The mean age of the patients was 52.3±8.9 years. Including CAC, the mean age was 70.5±13.4 years and the CAD risk was 9.5±8.8%. There was statistical correlation between hypertension (SAH) and CAC >400 (p=0,04; p<0,05); as well as between diabetes mellitus (DM) and CAC >400 (p=0,01; p<0,01). When the CAC was adjusted in percentiles, it was found that the presence of SAH demonstrated relevance with the percentile >75 (ra=4,8; p<0,01), as well as dyslipidemia with the percentile 50-75 (ra=2,7; p<0,01) and >75 (ra=2,5; p<0,01). On the other hand, the absence of SAH (ra=4,3; p<0,01) and dyslipidemia (ra=4,1; p<0,01) were protective factors, since they showed significance with the zero percentile.

Conclusions: This study has identified that elevated CAC showed relevance with DM, SAH and dyslipidemia, while the absence of SAH and dyslipidemia were cardiovascular protection factors.

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