Abstract
Background
Currently, 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.
Objective
We aimed to assess the prevalence and severity of calcified plaque in coronary arteries
in patients aged <40 years with and without diabetes.
Methods
We 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.
Results
The 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).
Conclusion
Our 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.
Keywords
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Article info
Publication history
Published online: August 23, 2013
Accepted:
August 16,
2013
Received in revised form:
April 14,
2013
Received:
January 28,
2013
Footnotes
Conflict of interest: Matthew Budoff is a consultant to General Electric, no other author has a conflict of interest.
Identification
Copyright
© 2013 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.
