Key result
Diabetes is linked to higher CAC prevalence, with multiple risk factors increasing odds ~47-fold.
Why the study?
The association and cumulative effect of cardiovascular risk factors on coronary artery calcium in hard-to-reach asymptomatic patients with diabetes were not well characterized.
Cross-Sectional (n=2,563)
No
Odds Ratio: 47.12 (95% CI 10.35–214.66)
Absolute Event Rate: 68.5% vs 53.8%
The cumulative burden of cardiovascular risk factors exponentially increases the odds of subclinical atherosclerosis in asymptomatic patients with diabetes.
Supports aggressive risk factor control in asymptomatic diabetes; extends cumulative burden data but remains hypothesis-generating.
AIM: To examine the association of cardiovascular disease risk factors with and their cumulative effect on coronary artery calcium in hard-to-reach asymptomatic patients with diabetes. METHODS: A total of 2563 community-dwelling asymptomatic subjects from Central Appalachia participated in coronary artery calcium screening at a heart centre. Binary variable was used to indicate that coronary artery calcium was either present or absent. Independent variables consisted of demographic and modifiable risk factors and medical conditions. Descriptive statistics and multinomial logistic regression analyses were conducted. RESULTS: In total, 55.8% and 13.7% of study participants had subclinical atherosclerosis (coronary artery calcium ⩾1) and diabetes, respectively. The presence of coronary artery calcium was higher in subjects with diabetes (68.5%) than those without (53.8%). Compared to subjects without diabetes with coronary artery calcium = 0, obesity, hypertension, hypercholesterolaemia and smoking increased the odds of the presence of coronary artery calcium (coronary artery calcium score ⩾1) regardless of diabetes status; however, with larger odds ratios in subjects with diabetes. Compared to subjects without diabetes with coronary artery calcium score = 0, having 3, 4 and ⩾5 risk factors increased the odds of presence of coronary artery calcium in subjects with diabetes by 14.06 (confidence interval = 3.26-62.69), 32.30 (confidence interval = 7.41-140.82) and 47.12 (confidence interval = 10.35-214.66) times, respectively. CONCLUSION: There is a need for awareness about subclinical atherosclerosis in patients with diabetes and more research about coronary artery calcium in subpopulations of patients.
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Mamudu et al. (2018) conducted a cross-sectional in Subclinical atherosclerosis (n=2,563). Diabetes and multiple cardiovascular risk factors vs. No diabetes was evaluated on Presence of coronary artery calcium (score ≥1) (OR 47.12, 95% CI 10.35-214.66). In asymptomatic subjects, diabetes was associated with a higher prevalence of coronary artery calcium (68.5% vs 53.8%), and having ≥5 risk factors increased the odds by 47.12 times.
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