Prevalence and severity of coronary artery calcium in young persons with diabetes |
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| Authors: | Nikhil Daga Khurram Nasir Yasmin Hamirani John Tayek Philip Bach Dong Li Matthew J Budoff |
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| Institution: | 1. Radiological Institute, Friedrich-Alexander-University-Erlangen-Nuremberg, Maximiliansplatz 1, 91054 Erlangen, Germany;2. Division of Cardiology, Department of Internal Medicine II, Friedrich-Alexander-University-Erlangen-Nuremberg, Erlangen, Germany;1. Department of Medicine, Cardiology Division, Medstar Georgetown University Hospital, 3800 Reservoir Road NW, 5PHC, Washington, DC 20007, USA;2. Siemens Healthcare, Forscheim, Germany;3. Austin Health, Melbourne, Australia;4. Department of Medicine, New York University School of Medicine, 660 First Ave, 2nd Floor, New York, NY 10016, USA;5. Department of Radiology, New York University School of Medicine, New York, NY, USA;1. Los Angeles Biomedical Research Institute, Torrance, CA, USA;2. Division of Cardiology, Department of Medicine, Harbor-UCLA Medical Center, 1124 W Carson Street, Bldg RB-2, Torrance, CA 90502-2064, USA;1. St Vincent’s Hospital, Sydney, Australia;2. University of New South Wales, Australia;3. King’s College London, Division of Imaging Sciences, The Rayne Institute, 4th Floor Lambeth Wing, St. Thomas’ Hospital, London SE1 7EH, United Kingdom;4. Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark;1. Divisions of Cardiology and Cardiac Imaging, St. Paul''s Hospital, University of British Columbia, 1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada;2. Divisions of Cardiology and Cardiac Imaging Center, Aarhus University Hospital Skejby, Aarhus, Denmark;3. Division of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA, USA;4. Québec Heart and Lung Institute, Laval University, Québec, QC, Canada;1. Department of Radiology (PGY-4), University of Florida, 1600 SW Archer Rd, Gainesville, FL 32608, USA;2. Department of Radiology (PGY-5), University of Florida, Gainesville, FL, USA;3. Division of Cardiac Imaging, Department of Radiology, University of Florida, Gainesville, FL, USA;4. University of Florida Congenital Heart Center, Department of Pediatric Cardiology, University of Florida, Gainesville, FL, USA |
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| Abstract: | BackgroundCurrently, American Diabetes Association guidelines suggest statin use among persons with diabetes mellitus aged >40 years. The presence of calcified plaque in coronary arteries is a sensitive surrogate of coronary artery disease and has been shown to be an independent predictor of mortality and cardiac events.ObjectiveWe aimed to assess the prevalence and severity of calcified plaque in coronary arteries in patients aged <40 years with and without diabetes.MethodsWe included 3723 asymptomatic patients aged <40 years who had undergone coronary calcium scanning. Clinical and demographic data were collected. Agatston score was categorized into Agatston score 0 as normal, 1 to 99 as low, 100 to 399 as intermediate, and ≥400 as severe; and statistical analysis was performed.ResultsThe study population consisted of 4% persons with diabetes (n = 142) and 56% men with a mean age of 35 ± 5 years. Young persons with diabetes had greater prevalence of Agatston score > 0 than persons without diabetes (43% vs 24%; P < .0001). In addition, 12% of persons with diabetes vs 2.5% of persons without diabetes had an Agatston score ≥ 100 (P < .0001). The prevalence of calcified plaque in coronary arteries was >50% in persons with diabetes aged >35 years. After taking into account risk factors, the presence of diabetes was associated with a 4-fold higher odds of an Agatston score ≥ 100 (odds ratio, 4.19; 95% CI, 2.29–7.65; P < .0001).ConclusionOur study found that 43% of young patients with diabetes have detectable coronary atherosclerosis. Given the known clinical implications of calcified plaque in coronary arteries, future studies are needed to evaluate interventions in persons aged <40 years who exhibit subclinical atherosclerosis to reduce future cardiovascular disease events in this vulnerable population. |
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| Keywords: | Diabetes Coronary artery calcium Prevalence Prognosis Atherosclerosis |
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