Coronary Artery Calcium Score as a Predictor of Coronary Stenosis in Patients with Diabetes Mellitus

Aim: To examine the association of cardiovascular disease risk factors with and their cumulative effect on coronary artery calcium in hard-to-reach asymptomatic patients with diabetes. Methods: A total of 2563 community-dwelling asymptomatic subjects from Central Appalachia participated in coronary artery calcium screening at a heart centre. Binary variable was used to indicate that coronary artery calcium was either present or absent. Independent variables consisted of demographic and modifiable risk factors and medical conditions. Descriptive statistics and multinomial logistic regression analyses were conducted. Results: In total, 55.8% and 13.7% of study participants had subclinical atherosclerosis (coronary artery calcium ⩾1) and diabetes, respectively. The presence of coronary artery calcium was higher in subjects with diabetes (68.5%) than those without (53.8%). Compared to subjects without diabetes with coronary artery calcium = 0, obesity, hypertension, hypercholesterolaemia and smoking increased the odds of the presence of coronary artery calcium (coronary artery calcium score ⩾1) regardless of diabetes status; however, with larger odds ratios in subjects with diabetes. Compared to subjects without diabetes with coronary artery calcium score = 0, having 3, 4 and ⩾5 risk factors increased the odds of presence of coronary artery calcium in subjects with diabetes by 14.06 (confidence interval = 3.26–62.69), 32.30 (confidence interval = 7.41–140.82) and 47.12 (confidence interval = 10.35–214.66) times, respectively. Conclusion: There is a need for awareness about subclinical atherosclerosis in patients with diabetes and more research about coronary artery calcium in subpopulations of patients.

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Bicuspid aortic valve is associated with less coronary artery calcium and coronary artery disease burden by computed tomography

European Heart Journal ◽

10.1093/eurheartj/ehab724.0173 ◽

2021 ◽

Vol 42 (Supplement_1) ◽

Author(s):

F Barbieri ◽

S Bleckwenn ◽

L Stoessl ◽

F Plank ◽

C Beyer ◽

...

Keyword(s):

Computed Tomography ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Aortic Valve ◽

Coronary Artery Calcium ◽

Coronary Stenosis ◽

Coronary Artery Calcium Score ◽

Calcium Score ◽

Stenosis Severity ◽

Artery Disease

Abstract Background Bicuspid aortic valve (BAV) is associated with genetic defects (NOTCH 1, GATA 5 mutations) and aortopathy. Differences in flow pattern and a genetic predisposition could also affect coronary arteries. Purpose To assess the coronary artery calcium score (CACS) and coronary artery disease (CAD) burden by coronary computed tomography angiography (CTA) in patients with BAV stenosis, as compared to those with tricuspid aortic valve (TAV) stenosis. Methods 47 patients with congenital BAV (68.9 years±12.9, 38.3% females) who underwent cardiovascular CTA for TAVR planning were matched with 47 TAV patients for age, gender, smoking, arterial hypertension, dyslipidemia, diabetes, body-mass-index and chronic kidney disease. The coronary artery calcium score (CACS) (Agatston Units=AU) and coronary stenosis severity by CTA (CADRAD:<25% minimal,<50%milde,50–70%moderate,>70/%severe) were quantified. Results The coronary artery calcium score (CACS) was lower in BAV (237.4 vs. 1013.3AU; p<0.001), and coronary stenosis severity was less (CAD-RAD:p<0.001) as compared to patients with TAV. More patients with BAV had CACS zero (27.7% vs. 0%, p<0.001). The majority (68.1%) of patients with BAV had no or non-obstructive CAD but only 25.5% of tricuspid (p<0.001). Obstructive CAD (>50% stenosis) by CTA was more frequently observed in TAV patients (68.1%; p<0.001). There were no differences in statin use and NOAC, and other co-morbidities such as AF and COPD. Conclusion Patients with BAV have markedly less coronary artery calcium load and yielded less severe coronary stenosis. CTA succeeds to rule out obstructive CAD in the majority of patients with BAV, with adherent implications for TAVR planning. FUNDunding Acknowledgement Type of funding sources: None. 72 YOM with BAV, zero CACS and no CAD CACS was lower in BAV

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