Subclinical coronary atherosclerosis identified by coronary computed tomographic angiography in asymptomatic morbidly obese patients
Abstract
Overview
Obesity is a common public health problem
and obese individuals in particular have a disproportionate
incidence of acute coronary
events. This study was undertaken to identify
coronary artery lesions as well as associated
clinical features, risk factors and demographics
in patients with a body mass index (BMI)
>40 kg/m2 without known coronary artery disease
(CAD). Morbidly obese subjects were
prospectively recruited to undergo coronary
computed tomographic angiography (CCTA)
using a dual-source computed tomography
(CT) system. CAD was defined as the presence
of any atherosclerotic lesion in any one coronary
artery segment. The presence, location,
and severity of atherosclerosis were related to
patient characteristics. Forty-one patients (28
women, mean age, 50.4±10.0 years, mean
BMI, 43.8±4.8 kg/m2) served as the study population.
Of these, 25 patients (61%) had at
least one coronary stenosis. All but 2 patients
within the CAD cohort had coronary artery calcium (CAC) scores >0, and most plaques identified
(75.4%) were non-calcified. There was a
predilection of calcified and non-calcified atherosclerosis
involving the left anterior
descending (LAD) coronary artery compared
with other coronary segments. Univariate predictors
of CAD included older age, dyslipidemia,
and diabetes. In this preliminary study
of young morbidly obese patients, CCTA
detected a high prevalence of calcified and
non-calcified CAD, although the later predominated.
Keywords
Computed tomography, morbid obesity, risk factors, atherosclerosis.
Article Information
Correspondence
Peter A. McCullough, Providence Park Heart Institute, St. John Providence Health System Novi, MI, USA E-mail: peteramccullough@gmail.com
Received
2010-07-21T00:00:00
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