Coronary Artery Calcium Score Compared with Cardio-Ankle Vascular Index in the Prediction of Cardiovascular Events in Asymptomatic Patients with Type 2 Diabetes

J Atheroscler Thromb. 2015;22(12):1255-65. doi: 10.5551/jat.29926. Epub 2015 Aug 13.

Abstract

Aim: Coronary artery calcium (CAC) score has a role in stratifying cardiovascular risk in patients with diabetes. Cardio-ankle vascular index (CAVI) is also a useful method to detect coronary artery calcification. This study compares CAC score with CAVI in the prediction of cardiovascular events in patients with diabetes.

Methods: From August 2006 to June 2008, a total of 626 patients with diabetes who received CAC score assessment with concomitant tests of ankle-brachial index and CAVI were included in this study.

Results: During 4 years of follow-up, 98 participants developed cardiovascular events. There is an increased incidence of coronary revascularization and total cardiovascular events with higher categories of CAC score (P < 0.05 when CAC score ≥ 100). The logistic regression analyses revealed pooled odd ratios for coronary revascularization, and total cardiovascular events were 1.25 [95% confidence interval (CI) 1.03- 1.51, P =0.021] and 1.23 (95% CI 1.07-1.42, P = 0.005), respectively, for high versus low CAVI (CAVI ≥ 9.0 vs CAVI < 9.0). The logistic regression model revealed that a CACscore of ≥ 1000 rather than a CAVI of ≥ 9.0 had a higher predictive value for total cardiovascular events.

Conclusions: A CAC score of ≥ 100 or a CAVI of ≥ 9.0 predicts future total cardiovascular events in asymptomatic patients with type 2 diabetes. Considering the advantages of CAVI, it can be used as one of the screening tools to reflect coronary atherosclerosis in these patients.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Ankle / blood supply
  • Ankle Brachial Index*
  • Calcium / metabolism*
  • Cardiovascular Diseases / diagnosis
  • Case-Control Studies
  • Coronary Artery Disease / complications
  • Coronary Vessels / diagnostic imaging*
  • Coronary Vessels / metabolism*
  • Diabetes Complications / blood
  • Diabetes Complications / diagnosis
  • Diabetes Mellitus, Type 2 / blood*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Multidetector Computed Tomography
  • Retrospective Studies
  • Risk Factors
  • Vascular Calcification / blood
  • Vascular Calcification / diagnostic imaging

Substances

  • Calcium