Key result
Diabetes is linked to ~70% higher odds of top-quartile CAC in asymptomatic individuals.
Why the study?
Among individuals with diabetes, coronary artery disease is a major cause of morbidity and mortality, but the age and gender distribution of coronary artery calcium by diabetes status in asymptomatic individuals was not well characterized.
Does diabetes status associate with a higher prevalence and burden of coronary artery calcium in asymptomatic individuals without known coronary artery disease?
Cross-Sectional (n=30,904)
Does diabetes status associate with a higher prevalence and burden of coronary artery calcium in asymptomatic individuals without known coronary artery disease?
Effect estimate: 70% greater likelihood
Asymptomatic individuals with diabetes, particularly younger ones, have a calcified plaque burden comparable to older nondiabetic individuals, highlighting the potential utility of CAC screening for risk stratification.
OBJECTIVES: We sought to examine the age and gender distribution of coronary artery calcium (CAC) by diabetes status in a large cohort of asymptomatic individuals. BACKGROUND: Among individuals with diabetes, coronary artery disease (CAD) is a major cause of morbidity and mortality. Electron-beam tomography (EBT) quantifies CAC, a marker for atherosclerosis. METHODS: Screening for CAC by EBT was performed in 30,904 asymptomatic individuals stratified by their self-reported diabetes status, gender, and age. The distribution of CAC across the strata and the association between diabetes and CAC were examined. RESULTS: Compared with nondiabetic individuals (n = 29,829), those with diabetes (n = 1,075) had higher median CAC scores across all but two age groups (women 40 to 44 years old and men and women > or =70 years old). Overall, the likelihood of having a CAC score in the highest age/gender quartile was 70% greater for diabetic individuals than for their nondiabetic counterparts. CONCLUSIONS: Younger diabetic individuals appear to have calcified plaque burden comparable to that of older individuals without diabetes. These findings call for future research to determine if EBT-CAC screening has an incremental value over the current CAD risk assessment of individuals with diabetes.
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Hoff et al. (2003) conducted a cross-sectional in Coronary artery disease (asymptomatic) (n=30,904). Diabetes vs. Nondiabetic individuals was evaluated on Likelihood of having a CAC score in the highest age/gender quartile (70% greater likelihood). Asymptomatic individuals with diabetes had a 70% greater likelihood of having a coronary artery calcium score in the highest age and gender quartile compared with nondiabetic individuals.
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