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Diabetologia
Erschienen in: Diabetologia 2/2005

01.02.2005 | Article

Coronary artery and abdominal aortic calcification are associated with cardiovascular disease in type 2 diabetes

verfasst von: P. D. Reaven, J. Sacks, Investigators for the VADT

Erschienen in: Diabetologia | Ausgabe 2/2005

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Abstract

Aims/hypothesis

The goals of this study were to determine whether coronary calcium is associated with the presence of clinical cardiovascular disease in individuals with type 2 diabetes and if the measurement of abdominal aortic calcium may have an independent or added benefit as a surrogate marker for clinical vascular disease.

Methods

A cross-sectional study of subjects with type 2 diabetes enrolled in seven medical centres in the USA participating in a Veterans Affairs Cooperative Study of glycaemic control. Enrolled subjects included 309 veterans over 40 years of age with type 2 diabetes, with or without stable cardiovascular disease, who had inadequate glycaemic control (HbA1c>7.5%) on oral agents and/or insulin. The study assessed lifestyle behaviours, standard cardiovascular risk factors and coronary artery and abdominal aorta calcification by electron beam computed tomography.

Results

Subjects with coronary artery or abdominal aorta calcification present had a strikingly higher prevalence of peripheral artery disease, coronary artery disease and all combined cardiovascular disease. Prevalence of each condition increased from 5- to 13-fold with increasing quintiles of coronary artery calcification and from 2- to 3-fold with increasing abdominal aorta calcification. These associations persisted after adjustment for lifestyle behaviours and standard cardiovascular risk factors.

Conclusions/interpretation

These results support the notion that vascular calcium in type 2 diabetes provides additional information beyond that of standard risk factors in identifying the presence of cardiovascular disease. Subclinical measures of atherosclerosis such as arterial calcification may help more precisely stratify these individuals and alert healthcare providers to those individuals who have particularly accelerated atherosclerosis.
Literatur
1.
Rumberger JA, Brundage BH, Rader DJ, Kondos G (1999) Electron beam computed tomographic coronary calcium scanning: a review and guidelines for use in asymptomatic persons. Mayo Clin Proc 74:243–252PubMed
2.
O’Rourke RA, Brundage BH, Froelicher VF et al. (2000) American College of Cardiology/American Heart Association Expert Consensus document on electron-beam computed tomography for the diagnosis and prognosis of coronary artery disease. Circulation 102:126–140
3.
Hosoi M, Sato T, Yamagami K et al. (2002) Impact of diabetes on coronary stenosis and coronary artery calcification detected by electron-beam computed tomography in symptomatic patients. Diabetes Care 25:696–701
4.
Raggi P, Callister TQ, Nicholas J, Lippolis D, Russo J (1999) Cardiac events in patients with progression of coronary calcification on electron beam computed tomography. Radiology 213:351
5.
Raggi P, Cooil B, Shaw LJ et al. (2003) Progression of coronary calcium on serial electron beam tomographic scanning is greater in patients with future myocardial infarction. Am J Cardiol 92:827–829CrossRef
6.
Kondos GT, Hoff JA, Sevrukov A et al. (2003) Electron-beam tomography coronary artery calcium and cardiac events: a 37-month follow-up of 5635 initially asymptomatic low- to intermediate-risk adults. Circulation 107:2571–2576CrossRefPubMed
7.
O’Malley PG, Taylor AJ, Jackson JL, Doherty TM, Detrano RC (2000) Prognostic value of coronary electron-beam computed tomography for coronary heart disease events in asymptomatic populations. Am J Cardiol 85:945–948CrossRef
8.
Detrano RC, Wong ND, Doherty TM et al. (1999) Coronary calcium does not accurately predict near-term future coronary events in high-risk adults. Circulation 99:2633–2638PubMed
9.
Greenland P, LaBree L, Azen SP, Doherty TM, Detrano RC (2004) Coronary artery calcium score combined with Framingham score for risk prediction in asymptomatic individuals. JAMA 291:210–215CrossRefPubMed
10.
Shaw LJ, Raggi P, Schisterman E, Berman DS, Callister TQ (2003) Prognostic value of cardiac risk factors and coronary artery calcium screening for all-cause mortality. Radiology 228:826–833PubMed
11.
Meigs JB, Larson MG, D’Agostino RB et al. (2002) Coronary artery calcification in type 2 diabetes and insulin resistance: the Framingham offspring study. Diabetes Care 25:1313–1319
12.
Hoff JA, Daviglus ML, Chomka EV, Krainik AJ, Sevrukov A, Kondos GT (2003) Conventional coronary artery disease risk factors and coronary artery calcium detected by electron beam tomography in 30,908 healthy individuals. Ann Epidemiol 13:163–169CrossRef
13.
Schurgin S, Rich S, Mazzone T (2001) Increased prevalence of significant coronary artery calcification in patients with diabetes. Diabetes Care 24:335–338
14.
Wolfe ML, Iqbal N, Gefter W, Mohler ER III, Rader DJ, Reilly MP (2002) Coronary artery calcification at electron beam computed tomography is increased in asymptomatic type 2 diabetics independent of traditional risk factors. J Cardiovasc Risk 9:369–376CrossRef
15.
Olson JC, Edmundowicz D, Becker DJ, Kuller LH, Orchard TJ (2000) Coronary calcium in adults with type 1 diabetes: a stronger correlate of clinical coronary artery disease in men than in women. Diabetes 49:1571–1578
16.
Raggi P, Shaw LJ, Berman DS, Callister TQ (2004) Prognostic value of coronary artery calcium screening in subjects with and without diabetes. J Am Coll Cardiol 43:1663–1669CrossRef
17.
Qu W, Le TT, Azen SP et al. (2003) Value of coronary artery calcium scanning by computed tomography for predicting coronary heart disease in diabetic subjects. Diabetes Care 26:905–910
18.
Detrano R (2003) Counterpoint: do people with diabetes benefit from coronary calcium scans? Diabetes Care 26:543–544
19.
Sarnelli R, Landini L, Squartini F (1986) Atherosclerosis detection by ultrasounds. A comparative histologic study on aortic specimens. Appl Pathol 4:270–275
20.
Giertsen JC (1964) Atherosclerosis in an autopsy series. 2. The lipoid and calcium contents of the aorta in childhood. Acta Pathol Microbiol Scand 61:233–242
21.
Abraira C, Duckworth W, McCarren M et al. (2003) Design of the cooperative study on glycemic control and complications in diabetes mellitus type 2. Veterans Affairs Diabetes Trial. J Diabetes Complications 17:314–322CrossRef
22.
Reaven PD, Thurmond D, Domb A, Gerkin R, Budoff MJ, Goldman S (2003) Comparison of frequency of coronary artery calcium in healthy Hispanic versus non-Hispanic white men by electron beam computed tomography. Am J Cardiol 92:1198–1200CrossRef
23.
Reaven PD, Sacks J (2004) Reduced coronary artery and abdominal aortic calcification in Hispanics with type 2 diabetes. Diabetes Care 27:1115–1120
24.
Agatston AS, Janowitz WR, Hildner FJ, Zusmer NR, Viamonte M Jr, Detrano R (1990) Quantification of coronary artery calcium using ultrafast computed tomography. J Am Coll Cardiol 15:827–832PubMed
25.
Duckworth WC, McCarren M, Abraira C (2001) Glucose control and cardiovascular complications: the VA Diabetes Trial. Diabetes Care 24:942–945
26.
Wilson PW, Kauppila LI, O’Donnell CJ et al. (2001) Abdominal aortic calcific deposits are an important predictor of vascular morbidity and mortality. Circulation 103:1529–1534
27.
Walsh CR, Cupples LA, Levy D et al. (2002) Abdominal aortic calcific deposits are associated with increased risk for congestive heart failure: the Framingham Heart Study. Am Heart J 144:733–739CrossRef
28.
Iribarren C, Sidney S, Sternfeld B, Browner WS (2000) Calcification of the aortic arch: risk factors and association with coronary heart disease, stroke, and peripheral vascular disease. JAMA 283:2810–2815CrossRefPubMed
29.
Simon A, Giral P, Levenson J (1995) Extracoronary atherosclerotic plaque at multiple sites and total coronary calcification deposit in asymptomatic men. Association with coronary risk profile. Circulation 92:1414–1421
30.
Solberg LA, Strong JP (1983) Risk factors and atherosclerotic lesions. A review of autopsy studies. Arteriosclerosis 3:187–198
Metadaten
Titel
Coronary artery and abdominal aortic calcification are associated with cardiovascular disease in type 2 diabetes
verfasst von
P. D. Reaven
J. Sacks
Investigators for the VADT
Publikationsdatum
01.02.2005
Erschienen in
Diabetologia / Ausgabe 2/2005
Print ISSN: 0012-186X
Elektronische ISSN: 1432-0428
DOI
https://doi.org/10.1007/s00125-004-1640-z

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