Altered coronary artery calcium scores before bariatric surgery

Obesity is an important cause of cardiovascular disease, especially coronary artery disease. Severely obese patients are particularly prone to this risk. The coronary artery calcium (CAC) score is a strong predictor of coronary heart disease and provides incremental information beyond traditional risk factors. We sought to determine the prevalence of abnormally high CAC scores in the preoperative setting among patients undergoing bariatric surgery and to establish risk predictors for higher scores.

We performed an observational study of 202 patients free of known coronary artery disease who were referred for bariatric surgery. In each patient, the presence of CAC was detected with computed tomography, and coronary risk variables were either measured or determined via questionnaire.

CAC was found in 14.4% of the overall population (26% of male and 10.5% of female patients). Participants with altered CAC scores were older (mean age, 46.8 years). The variables positively associated with an altered CAC score were older age, male sex, type 2 diabetes, hypertension, and hypercholesterolemia. Multivariate-adjusted analysis showed that age (OR, 1.11; 95% CI, 1.06-1.17; p = 0.001), male sex (OR, 4.17; 95% CI, 1.52-11.47; p = 0.006), and hypercholesterolemia (OR, 6.21; 95% CI, 1.81-21.29; p = 0.004) were most closely related to the presence of CAC.

Obese patients in the preoperative bariatric surgery setting have a high prevalence of abnormal CAC scores. Traditional risk factors play a important role in this scenario.