Determinants of Coronary Artery Calcium Score in Patients with Multifactorial Chylomicronemia Syndrome
Atherosclerosis（2023）
Hosp Civils Lyon | Hospices Civils Lyon | Carmen Laboratory
Abstract
Background and Aims: Coronary artery calcium score (CAC) improves cardiovascular (CV) risk prediction and is validated in many high risk populations such as type 1/type 2 diabetes and familial hypercholesterolemia. We aimed to characterize CAC distribution and determinants in patients with multifactorial hyperchylomicronemia syndrome (MCS) in primary CV prevention. Methods: Retrospective monocentric study, 164 MCS patients in primary prevention with a CAC assessment from 01/01/2011 to 31/08/2022. Results: The cohort had 79.3% of men. Mean age was 51.1±10.9 years. 48.2% of patients had type 2 diabetes, 45.1% hypertension (HTA), 34.7% had a history of acute pancreatitis. CAC median value was 1.0 (IQT 165) with the following distribution: CAC=0 47.1%, CAC 1- 100 23.2%, CAC 101-300 11.0% and CAC >300 18.9%. 48.2% of patients had CAC below the 25th percentile for age and sex and 34.1 % over the 75th. In univariate analysis, age, HTA, diabetes and smoking were significantly associated with a CAC >300 vs CAC=0 and with CAC >75th percentile vs <25th percentile. Sex and lipid parameters at the time of CAC assessment were not associated with the CAC score. In multivariate analysis (binary logistic regression), age, HTA, diabetes and smoking, remained significantly associated with CAC >300 vs CAC=0 and age, HTA, and smoking with CAC >75th percentile vs < 25th percentile. Conclusions: Traditional CV rick factors such as age, diabetes, HTA and smoking are the major determinants of CAC score. CAC may contribute to identify a subgroup of MCS patients at very high cardiovascular risk which might benefit for treatment intensification with new therapies.
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