Coronary disease & ACSCross-sectional study
Severe-extensive coronary atherosclerosis in low-risk individuals and absence of coronary atherosclerosis in high-risk individuals: the SCAPIS extremes project
- Cross-sectional study
- multicentre
- nationwide
- population-based
Authors' conclusion
SCORE2-risk correlated well with presence of coronary atherosclerosis, yet 1.9% non-diabetic subjects and 14.3% diabetic subjects display extreme coronary phenotypes with a mismatch between estimated cardiovascular risk and signs of coronary atherosclerosis.
Study context
- Population
- Randomly invited individuals aged 50–64 years (51% women) with coronary CT angiography (CAC score and segment involvement score)10,628 + 189 eligible
- Participants
- 30,154 participants
- Exposure
- Non-diabetic vs Diabetic
- Non-diabeticn = 10,628
- Diabeticn = 189
- Outcome
- Extreme phenotypes: no coronary atherosclerosis despite very high cardiovascular (CV) risk; severe-extensive coronary atherosclerosis despite low CV risk
Main finding
As reported in the abstract
No coronary plaques despite high SCORE2-risk
Severe-extreme coronary plaques despite low SCORE2-risk
Observational data: associations, not effects.
Further findings
Factors associated with severe-extensive plaque burden despite low Systematic Coronary Risk Evaluation (SCORE2)-risk (non-diabetic)
- More likely in men, with increasing age, more pack-years, previous smoking, hypertension, hyperlipidemia, family history of CVD and higher SBP
- all p<0.002
- Similar but reverse pattern among subjects without coronary plaques despite high SCORE2-risk
Factors associated with no coronary plaques despite high SCORE2-risk (diabetic)
- Higher likelihood of moderate physical activity, higher education levels and lower BMI
- P < 0.05
Original publication
Summarised from the published abstract; every number is checked against it