Coronary Artery Calcium Score Predicts Long-Term Cardiovascular Outcomes in Asymptomatic Patients with Type 2 Diabetes

Autor: Yu-Chen Hsu, Meng-Huan Lei, Sheng-Liang Chung, Yu-Lin Wu, Wei-Cheng Chen, Chao-Chin Chen
Rok vydání: 2021
Předmět:
Adult
Male
medicine.medical_specialty
endocrine system diseases
Coronary Artery Disease
Type 2 diabetes
030204 cardiovascular system & hematology
Asymptomatic
03 medical and health sciences
0302 clinical medicine
Internal medicine
Diabetes mellitus
Type 2 diabetes mellitus
Internal Medicine
medicine
Humans
cardiovascular diseases
Vascular Calcification
Aged
Primary prevention
Coronary artery calcium score
business.industry
Incidence (epidemiology)
Biochemistry (medical)
Hazard ratio
nutritional and metabolic diseases
Cardiovascular outcome
Odds ratio
Middle Aged
Prognosis
medicine.disease
Coronary Vessels
Confidence interval
Diabetes Mellitus
Type 2
Heart Disease Risk Factors
Cohort
cardiovascular system
population characteristics
Calcium
Female
Original Article
medicine.symptom
Cardiology and Cardiovascular Medicine
business
030217 neurology & neurosurgery
Zdroj: Journal of Atherosclerosis and Thrombosis
ISSN: 1880-3873
1340-3478
Popis: Aims: Type 2 diabetes mellitus (T2DM) is no longer regarded as a coronary risk equivalent, and heterogeneity of cardiovascular risk exists, suggesting that further risk stratification should be mandatory. This study aimed to determine the prevalence and clinical predictors of coronary artery calcium (CAC) score, and evaluate the CAC score as a predictor of cardiovascular outcome in a large asymptomatic T2DM cohort. Methods: A total of 2,162 T2DM patients were recruited from a Diabetes Shared Care Network and the CAC score was measured. Cardiovascular outcomes were obtained for 1,928 patients after a follow-up of 8.4 years. Multiple regression analysis and Cox proportional hazard regression were applied to identify clinical predictors of CAC and calculate the incidence and hazard ratios (HRs) for all-cause mortality and cardiovascular events by CAC category. Results: Of the recruited patients, 96.8% had one or more risk factors. The distribution of CAC scores was as follows: CAC=0 in 24.2% of the patients, 0 ＜CAC ≤ 100 in 41.5%, 100 ＜CAC ≤ 400 in 20.3%, CAC ＞400 in 14.7%. The multivariable predictor of increased CAC included age (years) (odds ratio, 1.07; 95% confidence interval, 1.06–1.08), male sex (1.82; 1.54–2.17), duration (years) of T2DM (1.07; 1.05–1.09), and multiple risk factors (1.94; 1.28–2.95). Increasing severity of CAC was associated with higher all-cause or cardiac mortality and higher incident cardiovascular events. The HRs for cardiac death or major cardiac events in CAC ＞400 vs CAC=0 were 8.67 and 10.52, respectively ( p ＜0.001) Conclusion: CAC scoring provides better prognostication of cardiovascular outcome than traditional risk factors in asymptomatic T2DM patients, and may allow identifying a high-risk subset for enhancing primary prevention.
Databáze: OpenAIRE
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