What is the clinical evidence from this study?

Study design: Cohort. Population: Asymptomatic individuals (n=10377). Intervention: Diabetes mellitus vs. No diabetes. Primary outcome: all-cause mortality (p=<0.0001).

What question did this study set out to answer?

The study aims to assess the impact of coronary artery calcium on predicting all-cause mortality in individuals with and without diabetes.

June 6, 2026Journal of the American College of Cardiology

Prognostic value of coronary artery calcium screening in subjects with and without diabetes

Q: What are the key findings of this study?

In asymptomatic individuals, diabetes was associated with higher all-cause mortality (3.5% vs 2.0%, P<0.0001), but diabetic patients with no coronary calcium had survival similar to nondiabetics.

Q: What question did this study set out to answer?

The study aims to assess the impact of coronary artery calcium on predicting all-cause mortality in individuals with and without diabetes.

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Key result

Zero coronary calcium is linked to similar survival in diabetic and nondiabetic individuals.

P<0.0001
n=10,377

Why the study?

Does coronary artery calcium score predict all-cause mortality differently in asymptomatic individuals with versus without diabetes?

Key Points

The study aims to assess the impact of coronary artery calcium on predicting all-cause mortality in individuals with and without diabetes.
Followed 10,377 asymptomatic individuals (903 diabetic) referred for electron beam tomography (EBT) imaging.
Average follow-up duration was 5.0 +/- 3.5 years.
Cox proportional hazard models were used to predict all-cause mortality, adjusting for other risk factors.
Average coronary calcium score (CCS) for diabetic subjects was 281 +/- 567 compared to 119 +/- 341 for non-diabetic subjects (p < 0.0001).
Death rate was 3.5% for diabetic subjects and 2.0% for non-diabetic subjects (p < 0.0001).
Significant interaction of CCS with diabetes was observed (p < 0.00001), indicating increased mortality risk in diabetic patients with higher CCS.

Study Design

Type

Cohort (n=10,377)

Structured PICO

Does coronary artery calcium score predict all-cause mortality differently in asymptomatic individuals with versus without diabetes?

Population

10,377 asymptomatic individuals (903 with diabetes) referred for EBT imaging, followed for an average of 5.0 years.

Exposure

Coronary artery calcium (CAC) screening via electron beam tomography (EBT)

Outcome

All-cause mortalityhard clinical

Main Result

Absolute Event Rate: 3.5% vs 2%

p-value: p=<0.0001

Discussion

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Implication

Coronary artery calcium scoring effectively stratifies mortality risk in asymptomatic diabetic patients, identifying a subgroup with zero calcium who have a very low short-term mortality risk comparable to non-diabetics.

Cite This Study

Raggi et al. (2004) conducted a cohort in Asymptomatic individuals (n=10,377). Diabetes mellitus vs. No diabetes was evaluated on all-cause mortality (p=<0.0001). In asymptomatic individuals, diabetes was associated with higher all-cause mortality (3.5% vs 2.0%, P<0.0001), but diabetic patients with no coronary calcium had survival similar to nondiabetics.

synapsesocial.com/papers/6a243a65ee4ed919607e64ed https://doi.org/10.1016/j.jacc.2003.09.068

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Prognostic value of coronary artery calcium screening in subjects with and without diabetes

Key Points

Study Design

Structured PICO

Main Result

Discussion

Implication

Cite This Study

Prognostic value of coronary artery calcium screening in subjects with and without diabetes

Key Points

Study Design

Structured PICO

Main Result

Discussion

Implication

Cite This Study

Also Consider

Also Consider