(Circulation. 2007;116:II_805.)
© 2007 American Heart Association, Inc.

Obesity: Causes and Cardiac Risk

Abstract 3557: Increased SkinCholesterol Identifies Individuals at Increased Cardiovascular Risk: The Predictor of Advanced Subclinical Atherosclerosis (PASA) Study

James H Stein¹; Wendy S Tzou²; Jeanne M DeCara³; Alan T Hirsch⁴; Emile R Mohler, III⁵; Pamela Ouyang⁶; Gregory L Pearce⁷; Michael H Davidson⁸

¹ Univ of Wisconsin Sch of Medicine and Public Health, Madison, WI
² Univ of Pennsylvania Sch of Medicine, Philadelphia, PA
³ Univ of Chicago Pritzker Sch of Medicine, Chicago, IL
⁴ Univ of Minnesota Sch of Public Health and Minneapolis Heart Institute Foundation, Minneapolis, MN
⁵ Univ of Pennsylvania Sch of Medicine, Philadelphia, PA
⁶ Johns Hopkins Univ Sch of Medicine, Baltimore, Baltimore, MD
⁷ Innovative Data Resources, Ashville, NC
⁸ Radiant Rsch, Chicago, IL

BackgroundSkincholesterol content (SC) is associated with the presence and extent of coronary artery disease among patients with cardiac symptoms; however, its relationship to subclinical arterial disease among asymptomatic individuals is unknown. The purpose of this multicenter study was to determine the relationships between SC, carotid intima-media thickness (CIMT), and the presence of carotid plaque in asymptomatic adults over a wide range of cardiovascular risk.

Methods SC was measured using a non-invasive point-of-care assay. CIMT and carotid plaque presence were determined by high-resolution B-mode ultrasound. Associations between SC, CIMT, carotid plaque presence, and cardiovascular risk factors were evaluated by multivariable logistic regression analyses.

Results SC and CIMT were measured in 565 asymptomatic individuals (age 57±10 years, 38% women) from 6 sites in North America. The mean Framingham 10-year cardiovascular risk was 8.4±7.2%. A 10-unit increase in SC was associated with a 12% increase in the odds of having increased CIMT (p=0.006) and a 15% increase in carotid plaque presence (p=0.002). Odds ratios (95% confidence intervals) associated with SC >110 U were 2.19 (1.25–3.85, p=0.006) for increased CIMT and 2.89 (1.61–5.19, p<0.001) for carotid plaque presence.

Conclusions SC identified the presence of two markers of advanced subclinical atherosclerosis. The relationships between increasing SC and both markers of subclinical atherosclerosis were consistent across all levels of cardiovascular risk and were independent of cardiovascular risk factors. SC may be a useful test for office-based cardiovascular risk prediction.