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Abstract
Background
Cardiovascular disease including coronary heart disease (CHD) is the most common cause of morbidity and mortality in patients with diabetes. But traditional risk factor assessment is limited to predict CHD in asymptomatic high-risk individuals. In this study, relationship between coronary calcium score (CCS) and CHD was evaluated to determine value of coronary artery calcification detected by multi-slice spiral computed tomography to predict CHD in high risk asymptomatic patients with type 2 diabetes.
Methods
127 patients were enrolled who admitted in Yeungnam University Hospital between December 2004 and May 2005. Standard cardiovascular risk factors and the CCS measured by multi-slice spiral computed tomography were assessed.
Results
Enrolled subjects were consisted of 56 subjects with diabetes and 71 subjects without diabetes. The mean CCS was significantly greater in patients with diabetes than without diabetics (p < 0.01). In both groups, patients with higher CCS had higher prevalence of CHD (p < 0.05). In all subjects, LDL cholesterol levels and CCS were significantly associated in multi-variate analysis (p < 0.05). In patients without diabetes, age was only associated with presence of CHD (p < 0.05). CCS was only associated with CHD in patients with diabetes, even after adjusting for the effects of age, LDL cholesterol and CRP (p < 0.05).
Figures and Tables
Fig. 1
Distribution of coronary calcium score in diabetics and non-diabetics. Total coronary calcium score was normalized by taking natural log of (1 + coronary calcium score). Diabetes group had higher coronary calcium score than non-diabetes group. Patients with significant coronary stenoses had significantly higher calcification scores than patients without stenoses in both the diabetic patients and non-diabetic patients.
Fig. 2
Distribution of coronary calcium score stratified by age in patients with and without diabetes (A) or in diabetics with and without coronary heart disease(B). Because coronary artery calcium accumulates exponentially in advanced lesions and in older patients, we plotted the log-transformed calcification score after adjusting for patient age.
Table 1
Clinical Characteristics of Study Population.
Data are expressed as mean ± SE.
BMI: body mass index, CCS: coronary calcium score, CRP: C-reactive protein, DBP: diastolic blood pressure, HDL-C: high density lipoprotein cholesterol, LDL-C: low density lipoprotein cholesterol, SBP: systolic blood pressure, TC: total cholesterol, TG: triglyceride.
*p < 0.05, compared with "without CHD".
†p < 0.01, compared with "without CHD".
Table 2
Clinical Characteristics of Subjects with or without Diabetes.
Data are expressed as mean ± SE.
BMI: body mass index, CCS: coronary calcium score, CRP: C-reactive protein, DBP: diastolic blood pressure, HDL-C: high density lipoprotein cholesterol, LDL-C: low density lipoprotein cholesterol, SBP: systolic blood pressure, TC: total cholesterol, TG: triglyceride.
*p < 0.05, compared with "without CHD".
†p < 0.01, compared with "without CHD".
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