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J Am Coll Cardiol, 2003; 41:1008-1012, doi:10.1016/S0735-1097(02)02975-3
© 2003 by the American College of Cardiology Foundation
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CLINICAL STUDY: DIABETES AND CARDIOVASCULAR DISEASE

The prevalence of coronary arterycalcium among diabetic individuals without known coronary artery disease

Julie Anne Hoff, PhD, RN*{dagger},*, Lauretta Quinn, PhD, RN{dagger}, Alexander Sevrukov, MD*, Rebecca B. Lipton, PhD, MPH, BSN{ddagger}, Martha Daviglus, MD, PhD§, Daniel B. Garside, MS§, Niraj K. Ajmere, BS*, Sanjay Gandhi, MD* and George T. Kondos, MD*

* Department of Medicine, Section of Cardiology, University of Illinois College of Medicine, Chicago, USA
{dagger} Department of Medical Surgical Nursing, University of Illinois College of Nursing, Chicago, USA
{ddagger} Division of Pediatric Endocrinology, University of Chicago, Chicago, USA
§ Department of Preventive Medicine, Northwestern University School of Medicine, Chicago, Illinois, USA

Manuscript received June 6, 2002; revised manuscript received November 15, 2002, accepted November 27, 2002.

* Reprint requests and correspondence: Dr. Julie Anne Hoff, DOM, Cardiology, 840 S. Wood Street (m/c 715), Chicago, Illinois 60612, USA.
jahoff{at}uic.edu

OBJECTIVES: We sought to examine the age and gender distribution of coronary artery calcium (CAC) by diabetes status in a large cohort of asymptomatic individuals.

BACKGROUND: Among individuals with diabetes, coronary artery disease (CAD) is a major cause of morbidity and mortality. Electron-beam tomography (EBT) quantifies CAC, a marker for atherosclerosis.

METHODS: Screening for CAC by EBT was performed in 30,904 asymptomatic individuals stratified by their self-reported diabetes status, gender, and age. The distribution of CAC across the strata and the association between diabetes and CAC were examined.

RESULTS: Compared with nondiabetic individuals (n = 29,829), those with diabetes (n = 1,075) had higher median CAC scores across all but two age groups (women 40 to 44 years old and men and women ≥70 years old). Overall, the likelihood of having a CAC score in the highest age/gender quartile was 70% greater for diabetic individuals than for their nondiabetic counterparts.

CONCLUSIONS: Younger diabetic individuals appear to have calcified plaque burden comparable to that of older individuals without diabetes. These findings call for future research to determine if EBT-CAC screening has an incremental value over the current CAD risk assesment of individuals with diabetes.

Abbreviations and Acronyms
  ARIC
  atherosclerosis Risk in Communities Study
  CAC
  coronary artery calcium
  CAD
  coronary artery disease
  EBT
  electron-beam tomography
  NHANES
  National Health And Nutrition Education Survey
  UIC
  University of Illinois at Chicago




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