Aterosclerose subclínica em pacientes assintomáticos de uma microrregião do sul do Brasil: análise comparativa entre escore de cálcio e EMIC

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Background: Cardiovascular diseases (CVD) are major causes of mortality worldwide. Coronary artery calcium (CAC) and carotid intima-media thickness (CIMT) are noninvasive tests for detecting atherosclerosis, recommended to complement the assessment of CVD-related risk factors. Objectives: To evaluate the applicability of the coronary calcium score and carotid ultrasound as complementary tools for screening subclinical atherosclerosis in asymptomatic middle-aged patients with cardiovascular risk factors treated in a microregion of southern Brazil. Methods: A cross-sectional study included 163 patients who underwent imaging examinations at a referral clinic in the Rio do Sul, Santa Catarina, microregion from January 2016 to December 2022. Statistical analysis was performed in SPSS® using Pearson's chi-square and Fisher's exact tests. For significant associations, adjusted residual analysis was performed to indicate the highest prevalence (ra≥1.96). Values of p≤0.05 were considered statistically significant. Results: The mean age was 56.4±7.8 years, with a higher prevalence of males (55.2%). There was a higher prevalence in the CAC percentiles zero (41.1%) and >75 (30.7%). On ultrasonography, 73.6% of patients did not present significant carotid atheromatosis (CIMT<1.0). Regarding changes in CAC, cardiovascular prevention was evidenced in women, (59.7%) being in the zero percentile (p=0.01). The absence of systemic arterial hypertension (SAH) proved to be a protective factor for the absence of subclinical atherosclerosis in CAC (p=0.02). A prevalence of 74.2% of males and 61.3% of family history of CVD were associated with the 50-75th percentile of CAC, both with an odds ratio of 2.3. Conclusions: CAC testing proved to be more relevant in detecting early atherosclerosis. Male patients have a statistically higher likelihood of presenting significant abnormalities in the tests, and women exhibit a cardiovascular protective factor.

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