Impact of body mass index and Framingham risk score on coronary artery plaque

It is still unclear whether traditional risk factors for heart disease and body weight correlate with the progression of left main coronary artery (LMCA) atherosclerosis. Thus, the aim of this study was to evaluate the cross-sectional relation between conventional risk score or metabolic disorder and non-stenotic LMCA atherosclerosis using intravascular ultrasound (IVUS).

We analyzed procedural and demographic data from 217 consecutive patients undergoing intervention for a left anterior descending or left circumflex coronary artery lesion, including their cardiovascular risk (Framingham risk score) and degree of adiposity. IVUS measurements for subclinical LMCA plaque were obtained in all patients and compared to their risk score (low, intermediate or high risk [< or =10%, 10-20%, and > or =20%, respectively]), with volumetric IVUS analyses being performed for the entire LMCA. Patients were further stratified by body weight (normal vs overweight/obesity [body mass index > or =25 kg/m2]).

Plaque volume index was greater in patients with high and intermediate risk groups compared to the low risk group (plaque volume index; 9.8 +/- 2.9 mm3/mm and 10.1 +/- 3.0 mm3/mm vs. 8.3 +/- 2.7 mm3/mm, p=0.017 and p=0.0002, respectively). Plaque volume index was also greater in patients in the overweight/obesity group compared to the normal weight group (plaque volume index; 10.2 +/- 2.9 mm3/mm vs 9.1 +/- 3.0 mm3/mm, p=0.005). Linear regression analysis identified overweight/obesity (p=0.034) and high 10-year CAD risk (p=0.003) as independent predictors of increased LMCA plaque volume index.

Conventional coronary risk factors, as well as adiposity itself, related to the volume of coronary plaque at non-stenotic LMCA.