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

P. D. Reaven, J. Sacks

Research output: Contribution to journalArticle

99 Scopus citations

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 (HbA 1c>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.

Original languageEnglish (US)
Pages (from-to)379-385
Number of pages7
JournalDiabetologia
Volume48
Issue number2
DOIs
StatePublished - Feb 1 2005
Externally publishedYes

Keywords

  • Aortic calcium
  • Arterial calcification
  • Atherosclerosis
  • Coronary calcium
  • Electron beam CT scan
  • Peripheral artery disease
  • Risk factors
  • Type 2 diabetes

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

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