ASSOCIATION BETWEEN PREOPERATIVE CARDIOVASCULAR RISK FACTORS AND CORONARY ARTERY CALCIUM SCORES IN PATIENTS UNDERGOING BARIATRIC SURGERY Cardiovascular risk and bariatric surgery

Background Obesity is associated with many factors that predispose to cardiovascular disease, including hypertension, dyslipidaemia, and diabetes. Bariatric surgery has been shown to decrease cardiovascular disease risk. Coronary artery calcium scoring (CACS) is a non-invasive imaging technique that quantifies intra-arterial calcium resulting from atherosclerosis. Elevated CACS has been shown to be correlated with cardiovascular disease progression and morbidity. Currently it is not well established whether morbidly obese patients carry a coronary artery calcium burden or which factors are associated with a higher CACS in a bariatric surgical population pre-operatively. Methods Patients with no prior cardiovascular disease undergoing bariatric surgery were evaluated preoperatively for CACS. Age, sex, smoking status, diabetes status, blood pressure, serum lipids, pre- and post- operative weight and height were also recorded. A ten-year risk of fatal cardiovascular disease was calculated using the European Society of Cardiology’s SCORE tool. Patients were grouped into CACS=0 and CACS\u003e0. Statistical analysis was performed utilizing the Student’s T-test for continuous variables and Chi Square test for categorical variables. P-values less than 0.05 were considered statistically significant. Results Between June 2008 and June 2019, 154 patients were evaluated. The mean (sd) age was 44(11) years. Thirty-six (23%) were male. Forty-eight (31%) patients had subclinical coronary artery calcium scores. Risk factors that were associated with CACS\u003e0 were older age (mean 53(6) vs 40(10) years, p 0 (mean 1.2(1.28) vs 0.29(0.73), p Conclusions Our study demonstrates that coronary artery calcium is associated with adverse cardiovascular risk factors in morbidly obese patients. Interestingly, patients with absent coronary artery calcium had a greater excess weight loss by 12 months (range 6–24) following surgery. Coronary artery calcium scoring may be a useful tool in helping further stratify cardiovascular risk and operative outcomes in bariatric populations.