European Journal of Cardiovascular Medicine

Background: The Calcium Score (CS) is a pre clinical index of atherosclerosis and the prediction of cardiovascular risk is more accurate if CS is included. Current guidelines recommend the use of CS scoring for cardiovascular risk with intermediate-risk patients but there is not established the role of CS in patient with low risk factors.Objective: To define the prognostic significance of CS in smokers (SMO) or not smokers (NSMO)without symptoms. Diabetic patients were excluded in the first analysis.Methods: we’ve studied, in primary prevention, 32 not diabetic patients, 16 females and 16 males, range 60 ± 15 years old, with a metabolic syndrome based on the Third Adult Treatment Panel ATP III criteria of the National Cholesterol Education Program. Patients underwent to a heart coronary CT angiography (HCCT), a not invasive procedure. We have classified the patients into two groups: SMO (a pack of cigarettes for 10 years minimum) and NSMO (In NSMO category are included adults patients that have never smoked or have smoked not more than 100 cigarettes during their entire life). The SMO displayed have higher CS (94 (3;301.5) vs 0 (0;10.2); p<0.001), in comparison with NSMO. Accordingly, the associations between CS and cigarette smoking was still maintained after adjustment for age (rs 0.317; p<0.05). Finally, multiple regression analysis showed that smoke was the variable that best predicted the CST variance (R2 0.131; ®-standardised coefficient 0.362; p<0.05) . Results: CS gravity and extension have been elevated in smokers and the statistical correlation has been highly significant. CS is related to age, epicardial fat and smoke. Stepwise analysis demonstrated that smoke parameter is independent to age and epicardial fat. Conclusions: CS score offers a direct measurement of subclinical coronary pathology. Our study demonstrates that smokers have an elevated CS and the CS, in our opinion, is absolutely useful for the screening of coronary disease in asymptomatic smokers.