Silent coronary heart disease in patients with type 2 diabetes: application of a screening approach in a follow-up study

Objective To examine the utility of repeated computed tomography (CT) coronary artery calcium (CAC) testing, we assessed risks of detectable CAC and its cardiovascular consequences in individuals with and without type 2 diabetes from ages 45 to 85 years. Research Design and Methods We included 5836 individuals (618 with type 2 diabetes, 2972 without baseline CAC) from the Multi-Ethnic Study of Atherosclerosis. Logistic and Cox regression evaluated the impact of type 2 diabetes, diabetes treatment duration and other predictors on prevalent and incident CAC. We used time-dependent Cox modeling of follow-up data (median 15.9 years) for two repeat CT exams and cardiovascular events to assess the association of CAC at follow-up CT with cardiovascular events. Results For 45-year-olds with type 2 diabetes, the likelihood of CAC at baseline was 23% versus 17% for those without. Median age at incident CAC was 52.2 versus 62.3 years for those with and without diabetes. Each 5 years of diabetes treatment increased the odds and hazard rate of CAC by 19% (95% confidence interval [CI] 8-33%) and 22% (95% CI 6-41%). Male gender, white ethnicity/race, hypertension, hypercholesterolemia, obesity, and low serum creatinine also increased CAC. CAC at follow-up CT independently increased coronary heart disease rates. Conclusions We estimated cumulative CAC incidence to age 85. Patients with type 2 diabetes develop CAC at a younger age than those without diabetes. Because incident CAC is associated with increased coronary heart disease risk, the value of periodic CAC-based risk assessment in type 2 diabetes should be evaluated.

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Quality and Quantity of Protein Intake Influence Incidence of Type 2 Diabetes Mellitus in Coronary Heart Disease Patients: From the CORDIOPREV Study

Nutrients ◽

10.3390/nu13041217 ◽

2021 ◽

Vol 13 (4) ◽

pp. 1217

Author(s):

Silvia de la Cruz-Ares ◽

Francisco M. Gutiérrez-Mariscal ◽

Juan F. Alcalá-Díaz ◽

Gracia M. Quintana-Navarro ◽

Alicia Podadera-Herreros ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Coronary Heart Disease ◽

Type 2 Diabetes Mellitus ◽

Heart Disease ◽

Protein Intake ◽

Plant Protein ◽

Oral Glucose

Evidence suggests that enriching a diet with plant-based proteins could reduce the risk of developing type 2 diabetes mellitus. In the present work, we evaluated the association between the change in plant protein intake (adjusted by energy) and incidence of type 2 diabetes mellitus in patients with coronary heart disease from the CORDIOPREV (coronary diet intervention with olive oil and cardiovascular prevention) study. At baseline and during the follow-up, patients underwent medical examination and blood and oral glucose tolerance tests. Information on patient’s dietary intake was gathered by registered dietitians using a validated food frequency questionnaire. A total of 106 out of 436 nondiabetic patients at baseline developed type 2 diabetes mellitus after a median follow-up of 60 months. Cox regression analyses showed that patients who belonged to the group that increased plant protein intake exhibited a lower risk of developing the disease (HR = 0.64, (0.43–0.96)). Changes in plant protein intake were positively correlated with changes in carbohydrates, fibre, and legumes intake and negatively correlated with changes in saturated fatty acids intake. Results of the present study support the need of improving diet with plant-based proteins to prevent the onset of type 2 diabetes mellitus.

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High-Sensitivity C-Reactive Protein and Coronary Heart Disease Mortality in Patients With Type 2 Diabetes: A 7-year follow-up study

Diabetes Care ◽

10.2337/diacare.29.02.06.dc05-1700 ◽

2006 ◽

Vol 29 (2) ◽

pp. 329-333 ◽

Cited By ~ 94

Author(s):

M. Soinio ◽

J. Marniemi ◽

M. Laakso ◽

S. Lehto ◽

T. Ronnemaa

Keyword(s):

Type 2 Diabetes ◽

Coronary Heart Disease ◽

High Sensitivity ◽

Coronary Heart Disease Mortality ◽

C Reactive Protein ◽

Reactive Protein ◽

Follow Up Study ◽

Disease Mortality

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Joint effects of history of hypertension at baseline and type 2 diabetes at baseline and during follow-up on the risk of coronary heart disease

European Heart Journal ◽

10.1093/eurheartj/ehm501 ◽

2007 ◽

Vol 28 (24) ◽

pp. 3059-3066 ◽

Cited By ~ 55

Author(s):

G. Hu ◽

P. Jousilahti ◽

J. Tuomilehto

Keyword(s):

Type 2 Diabetes ◽

Coronary Heart Disease ◽

Heart Disease ◽

Joint Effects ◽

History Of

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Long-term Predictions of Incident Coronary Artery Calcium to 85 Years of Age for Asymptomatic Individuals with and without Type 2 Diabetes

10.2337/figshare.14365538.v1 ◽

2021 ◽

Author(s):

Bart S. Ferket ◽

M.G. Myriam Hunink ◽

Umesh Masharani ◽

Wendy Max ◽

Joseph Yeboah ◽

...

Keyword(s):

Type 2 Diabetes ◽

Coronary Heart Disease ◽

Heart Disease ◽

Coronary Artery ◽

Coronary Artery Calcium ◽

Cardiovascular Events ◽

Diabetes Treatment ◽

The Impact

Objective To examine the utility of repeated computed tomography (CT) coronary artery calcium (CAC) testing, we assessed risks of detectable CAC and its cardiovascular consequences in individuals with and without type 2 diabetes from ages 45 to 85 years. Research Design and Methods We included 5836 individuals (618 with type 2 diabetes, 2972 without baseline CAC) from the Multi-Ethnic Study of Atherosclerosis. Logistic and Cox regression evaluated the impact of type 2 diabetes, diabetes treatment duration and other predictors on prevalent and incident CAC. We used time-dependent Cox modeling of follow-up data (median 15.9 years) for two repeat CT exams and cardiovascular events to assess the association of CAC at follow-up CT with cardiovascular events. Results For 45-year-olds with type 2 diabetes, the likelihood of CAC at baseline was 23% versus 17% for those without. Median age at incident CAC was 52.2 versus 62.3 years for those with and without diabetes. Each 5 years of diabetes treatment increased the odds and hazard rate of CAC by 19% (95% confidence interval [CI] 8-33%) and 22% (95% CI 6-41%). Male gender, white ethnicity/race, hypertension, hypercholesterolemia, obesity, and low serum creatinine also increased CAC. CAC at follow-up CT independently increased coronary heart disease rates. Conclusions We estimated cumulative CAC incidence to age 85. Patients with type 2 diabetes develop CAC at a younger age than those without diabetes. Because incident CAC is associated with increased coronary heart disease risk, the value of periodic CAC-based risk assessment in type 2 diabetes should be evaluated.

Download Full-text