Coronary artery calcium and cardiovascular risk in diabetes |
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| Authors: | RS Elkeles |
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| Institution: | 1. Department of Medical Physics, Faculty of Life Sciences, Kumamoto University, 4-24-1 Kuhonji, Kumamoto, Japan;2. Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan;3. The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, USA;4. Department of Radiology, Kumamoto University Hospital, Kumamoto, Japan;1. Department of Central Laboratory, Affiliated Haikou Hospital of Xiangya Medical College, Central South University, Haikou, Hainan 570208, China;2. State Key Lab of Marine Resource Utilization in South China Sea, School of Materials Science and Engineering, Hainan University, Haikou, Hainan 570228, China;1. Department of Radiology, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, OH, USA;2. Division of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, MD, USA |
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| Abstract: | Measurement of coronary artery calcium score (CACS) by electron beam tomography has been shown to a powerful predictor of coronary heart disease events in asymptomatic non-diabetic subjects. In type 2 diabetes, measurement of CACS was found to be a powerful predictor of cardiovascular events which could enhance prediction provided by established risk models. 23% of type 2 diabetic subjects with low CACS were found to be at low risk for cardiovascular events. Moreover mortality was similar for type 2 diabetic and non-diabetic subjects with undetectable coronary artery calcification. Conversely type 2 diabetic subjects with high CACS were identified who were at high cardiovascular risk. Thus not all those with type 2 diabetes are at similar cardiovascular risk. Measurement of CACS enables cardiovascular risk in type 2 diabetes to be stratified so that the level of preventive therapy could be reduced in some and intensified in others. Although prospective data for the power of CACS to predict CHD events in type 1 diabetes are lacking, measurement of CACS could help in deciding on preventive therapy in type 1 diabetes. |
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