Literature DB >> 12610057

Value of coronary artery calcium scanning by computed tomography for predicting coronary heart disease in diabetic subjects.

Wenchun Qu1, Thuy T Le, Stanley P Azen, Min Xiang, Nathan D Wong, Terence M Doherty, Robert C Detrano.   

Abstract

OBJECTIVE: The South Bay Heart Watch is a cohort study designed to determine the significance of coronary calcium in high-risk asymptomatic patients. This is a report of the relative risk (RR) for outcomes of coronary artery calcium in diabetic and nondiabetic subjects. RESEARCH DESIGN AND METHODS: A total of 1312 diabetic and nondiabetic subjects underwent risk factor screening and computed tomography testing for coronary calcium at baseline and were followed clinically for 6.3 +/- 1.4 years. End points were either 1). hard events of nonfatal myocardial infarction (MI) or coronary death or 2). any cardiovascular event (nonfatal MI, coronary death, coronary revascularization, or stroke).
RESULTS: The incidence rates of a hard event and any cardiovascular event for diabetic and nondiabetic subjects were 14.5 and 6.1% and 23.8 and 12.2%, respectively (P < 0.001). Cox regression analyses of the combined risk relationship of diabetes status and calcium score demonstrated that relative to nondiabetic subjects with low calcium scores (<2.8), diabetic subjects with calcium scores >or=2.8 exhibited at least a fourfold increase in the risk of either a hard or any cardiovascular event (P < 0.001). Cox regression analyses conducted separately for nondiabetic and diabetic subjects revealed that coronary calcium score risk groups were significantly associated with events in nondiabetic subjects (RR >or= 2.6, P <or= 0.01), but not in diabetic subjects (RR <or= 1.7, P > 0.05).
CONCLUSIONS: The risk of coronary heart disease increases with increasing calcium scores and diabetes status. Calcium scores have less prognostic value in diabetic subjects.

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Year:  2003        PMID: 12610057     DOI: 10.2337/diacare.26.3.905

Source DB:  PubMed          Journal:  Diabetes Care        ISSN: 0149-5992            Impact factor:   19.112


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