Association of Blood Lipids With Coronary Artery Plaque Among Saudi Patients Referred to Computed Tomography

Abstract

BACKGROUND: Blood lipids are strong risk factor for the progression of atherosclerotic plaques. However, data on gender-specific associations are limited OBJECTIVES: To examine gender-specific associations of blood lipids with coronary plaque among in a large sample of asymptomatic Saudi patients. METHODS: Retrospective cross-sectional study was conducted among adult patients referred to (64 multidetector spiral) computed tomography (CT) for standard indications at the Prince Sultan Cardiac Centre (Riyadh, Saudi Arabia) between July 2007 and December 2017. Those with pre-existing CAD were excluded. Plaques were determined based on post-test CT angiography and coronary calcification. RESULTS: A total 2421 patients (1498 males and 923 females) were included. The prevalence of any plaque was 36.6% with higher burden in males than females (41.3% versus 28.9%, p<0.001). Approximately 78.9% of all plaques were calcified. Blood lipids (mmol/L) were 4.75±1.14 for total cholesterol, 2.90±0.96 for LDL cholesterol, 1.20±0.36 for HDL cholesterol, and 1.64±1.09 for triglycerides. Males had significantly higher triglycerides and lower HDL cholesterol compared with females. In adjusted models in males and all patients, soft and/or calcified plaques were significantly associated with lower HDL cholesterol and higher triglycerides. In females, the only significant association was between soft plaques and higher triglycerides.CONCLUSIONS: Middle-aged patients without clinical CAD in Saudi Arabia have a high burden of plaques, specially calcified ones. The findings may impact the use of lipid lowering mediations, by underscoring the importance of assessing the risk of CAD in asymptomatic patients without clinical CAD even in case of lack of coronary calcification.