Clinical Investigations: Imaging and Diagnostic TestingDiabetes and the associated incidence of subclinical atherosclerosis and coronary artery disease: Implications for management☆
Section snippets
Patient population
We enrolled 2 cohorts of diabetic patients to evaluate the differences in prevalence and extent of disease. All patients underwent EBT for evaluation of CC.
Symptomatic cohort
The symptomatic population (n = 168) consisted of patients undergoing coronary angiography for suspicion of obstructive CAD. These symptomatic diabetic patients were excluded if patients declined to participate, refused to sign informed consent, or had previous revascularization. The patients enrolled consisted of almost exclusively type 2
Patient demographics
A total of 323 patients with diabetes, 208 men (64%) and 115 women (36%), were studied. The mean age was 58 ± 9 years, ranging from 31 to 82 years. Diabetic persons in our population were found to have an average of 2.06 nondiabetic cardiac risk factors, which included age, tobacco use, hypercholesterolemia, hypertension, and family history. There were no statistical differences between men and women with regard to prevalence of nondiabetic risk factors.
Symptomatic cohort
We enrolled 168 (52%) symptomatic
Diabetes as a cardiovascular risk factor
Cardiovascular disease is the cause of death in 65% of persons with diabetes, whereas only 35% of deaths in nondiabetic subjects can be attributed to CVD.7 The aggressive management of this cohort (especially in regard to widespread cholesterol therapy) is still somewhat controversial. It has been well established that CC is proportional to the atherosclerotic burden.13, 14, 15, 16, 17, 18 EBT allows for the detection and quantification of CC and is reproducible and independent of user
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Low short-term and long-term cardiovascular and all-cause mortality in absence of coronary artery calcium: A 22-year follow-up observational study from large cohort
2019, Journal of Diabetes and its ComplicationsNLRP3 inflammasome as a treatment target in atherosclerosis: A focus on statin therapy
2019, International ImmunopharmacologyNoninvasive Cardiovascular Risk Assessment of the Asymptomatic Diabetic Patient: The Imaging Council of the American College of Cardiology
2016, JACC: Cardiovascular ImagingCitation Excerpt :Furthermore, numerous studies have conclusively proven that CAC scores predict incident CAD in the general population (36,37). Patients affected by type 2 DM harbor larger amounts of CAC than nondiabetic patients of a similar age (38); additionally the extent (39,40) and prevalence (41) of CAC in patients with type 2 diabetes asymptomatic for CAD is similar to that of patients with established CAD but without diabetes. Unlike the general population, women and men with type 2 DM have a similar extent of CAC, confirming the clinical evidence that diabetes negates the well-known advantage of women over men in prevalence and extent of atherosclerosis (39,41).
Carotid intima-media thickness is a useful screening tool to detect coronary artery plaque in type 2 diabetic patients with zero calcium score
2014, International Journal of CardiologyPrevalence and severity of coronary artery calcium in young persons with diabetes
2013, Journal of Cardiovascular Computed TomographyCitation Excerpt :Thus, asymptomatic adults < 40 years of age with diabetes have more prevalent calcified plaque in coronary arteries and severe Agatston scores than young adults without diabetes. These results suggest that many young adults with diabetes may be at increased risk, despite lack of cardiac symptoms.17,18,22–24 The findings of our study, indicating significant prevalence of calcifications in younger persons with diabetes, suggest that other methods of identifying cardiovascular risk in asymptomatic young persons with diabetes, such as coronary calcium assessment, may be needed as a tool in primary prevention in this population.
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Reprint requests: Matthew J. Budoff, MD, FACC, St John’s Cardiovascular Research Center, 1124 W Carson St, RB2, Torrance, CA 90502. E-mail: [email protected]