CONGRESS ABSTRACT

Background Despite significant progress in managing conventional cardiovascular (CV) risk factors, countless CV events still occur in individuals without overt traditional risks. This underscores the need for a more comprehensive understanding of non-traditional risk factors and a more effective integration of risk scoring systems into clinical practice. Methods This study analyzed data from CV-PREVITAL study, a multicentre, prospective, randomized, controlled, open-label interventional trial designed to compare the effectiveness of an educational mobile health intervention versus usual care in reducing CV risk among 10,000 Italian patients. Our local cohort enrolled 1041 subjects, followed over a mean follow-up period of 12 months.  Data collected include: Clinical Assessment: A comprehensive evaluation included medical history; anthropometric measurements; blood pressure measurements, lipid panels, glucose levels, glycated haemoglobin, high-sensitivity C-reactive protein (hs-CRP), echocardiogram, electrocardiogram, and Doppler ultrasound of carotid and femoral arteries.   Questionnaires: Pittsburgh Sleep Quality Index (PSQI) to assess sleep disturbances. Occupational status Standardized dietary and physical activity questionnaires to evaluate lifestyle factors. Environmental Exposure Analysis: Individual exposure to air pollutants, specifically PM2.5 and PM10, was estimated through geospatial mapping integrated with air quality monitoring data. Results Our study identified a surprisingly modest correlation between LDL cholesterol levels and carotid subclinical atherosclerosis (OR [95% CI]: 1.006, p = 0.05). Reduced HDL cholesterol levels and elevated triglyceride concentrations demonstrated significant associations with subclinical atherosclerosis. Elevated hs-CRP levels correlate with subclinical atherosclerosis (OR [95% CI]: 1.027, p = 0.08); however, statistical significance was lost after multivariable adjustment, consistent with previous retrospective studies. Notably, exposure to PM2.5, as well as sleep quality, anxiety, and depression, did not show any associations with carotid subclinical atherosclerosis. Conclusions Our findings underscore the importance of a more nuanced understanding of the interplay between conventional and unconventional risk factors (inflammatory markers), supporting a more personalized approach to CV disease prevention.