THU600 Coronary Calcium Scores In Medical Group Versus Individualized Dietitian-led Visits Group In An Inner-city Setting

Disclosure: T.C. Friedman: None. P. Duran: None. M.J. Budoff: None. M. Shaheen: None. Obesity is highly prevalent in the U.S., particularly among ethnic minority groups. The purpose was using a randomized trial of 12-months to evaluate if coronary artery calcium (CAC) scores will decline in the medical arm compared to the dietitian-led arm and the control arm. Adult patients were recruited from LAC-DHS and randomized to medical group visit (n=58), dietitian individual visit (n=18) and control (n=50) groups. We measured the total CAC score and left anterior descending [LAD] scores using cardiac computed tomography to quantify CAC. We analyzed data for the change from baseline in the CAC scores between groups using the Kruskal Wallis test. We categorized the total CAC scores into 0-100 (no/mild risk); 101-400 (moderate risk); and > 400 (severe risk) and the LAD score into 0-99 (no/mild risk); 100-300 (moderate risk); and >300 (severe risk) and compared the groups using chi square or fisher exact test. P-value <0.05 was statistically significant. No statistical difference was found between the study groups in the change of the total CAC score. The mean, median and IQR of the change in total CAC score were -26.4, 0.0,3.0 in the dietitian group; 21.6, 0.0, 10.0 in the medical group; 44.6, 3.0, 23.0 in the control group (p=0.10). At baseline and post-intervention, no significant differences were found between the study groups in the total CAC risk (p=0.22). The mean, median and inter-quartile range (IQR) of the change in LAD score were -23.6, 0.0, 2.0 in the dietitian group; 4.7, 0.0, 2.0 in the medical group; 12.5, 1.0, 9.8 in the control group (p=0.036). Significant improvements were found between the dietitian group and control group (p=0.039) and the medical group and control group (p=0.027). For LAD risk groups at baseline, 10%, 11.1% and 10.3% of the control, dietitian, and medical groups, respectively, had moderate risk; and 10.0%, 5.6%, and 1.7%, respectively, had severe risk (p=0.069). Post intervention, there was a reduction in the percent with moderate risk in the dietitian (-5.5%) and the medical (-1.7%) groups relative to control group (2.0%). For the severe risk, there was a reduction of 5.6% in the dietitian group, with no change in the medical group relative to 2% increase in the control group (p=0.013). Our study showed significant improvement in the LAD score and its risk groups in the dietitian group relative to the control and medical groups indicating that the dietitian intervention was able to attenuate the progression of atherosclerosis. The implications of our study is that lifestyle obesity interventions have the potential to reduce cardiovascular disease. Presentation: Thursday, June 15, 2023