Coronary age, based on coronary calcium measurement, is increased in patients with morbid obesity

Abstract

PurposeObesity is a well-known of risk factor for atherosclerosis. However, recently an “obesity paradox” has been discussed, which is considered as a protective effect of obesity on the development coronary artery disease (CAD). An aim of the study was to investigate the risk of CAD in morbidly obese patients using coronary artery calcium measurement.Material and methodsFifty-one patients with morbid obesity (BMI ≥ 40 kg/m2) and thirty controls were scanned to determine the amount of coronary artery calcification (CAC), which was expressed as calcium score (CS) and coronary age (CA). The control group consisted of patients scanned for the clinical suspicion of CAD, who did not fulfil the criteria of obesity.ResultsMean BMI of obese patients and controls was 47.3 and 26.5, respectively (p < 0.0001). Arterial hypertension, dyslipidaemia, and smoking were more frequent in the control group than in the obesity group (p < 0.02). The prevalence of CAC was higher in the obesity group (53% vs. 23%, p < 0.01). The groups did not differ regarding CS and CA. However, the difference between coronary age and metrical age was higher in obese patients than in controls (+5.6 vs. –4.8 years, respectively, p < 0.005).ConclusionsPatients with morbid obesity present an increased risk of CAD that is reflected by the difference between their coronary age and metrical age.

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“…In support of the role of obesity as a coronary risk factor, one study detected significantly higher prevalence of CAC in obese than in non-obese (39) and CAC score of 1-99 AU predict high-risk plaque (40). Moreover, it was found that bariatric surgery for severe obesity significantly reduces the future risk of developing CV comorbidities with significant reduction in CAC scores (41).…”