J Greg Terry
Investigator
Last active: 9/4/2019

Associations of coronary artery calcified plaque density with mortality in type 2 diabetes: the Diabetes Heart Study.

Raffield LM, Cox AJ, Criqui MH, Hsu FC, Terry JG, Xu J, Freedman BI, Carr JJ, Bowden DW
Cardiovasc Diabetol. 2018 17 (1): 67

PMID: 29751802 · PMCID: PMC5946410 · DOI:10.1186/s12933-018-0714-z

BACKGROUND - Coronary artery calcified plaque (CAC) is strongly predictive of cardiovascular disease (CVD) events and mortality, both in general populations and individuals with type 2 diabetes at high risk for CVD. CAC is typically reported as an Agatston score, which is weighted for increased plaque density. However, the role of CAC density in CVD risk prediction, independently and with CAC volume, remains unclear.

METHODS - We examined the role of CAC density in individuals with type 2 diabetes from the family-based Diabetes Heart Study and the African American-Diabetes Heart Study. CAC density was calculated as mass divided by volume, and associations with incident all-cause and CVD mortality [median follow-up 10.2 years European Americans (n = 902, n = 286 deceased), 5.2 years African Americans (n = 552, n = 93 deceased)] were examined using Cox proportional hazards models, independently and in models adjusted for CAC volume.

RESULTS - In European Americans, CAC density, like Agatston score and volume, was consistently associated with increased risk of all-cause and CVD mortality (p ≤ 0.002) in models adjusted for age, sex, statin use, total cholesterol, HDL, systolic blood pressure, high blood pressure medication use, and current smoking. However, these associations were no longer significant when models were additionally adjusted for CAC volume. CAC density was not significantly associated with mortality, either alone or adjusted for CAC volume, in African Americans.

CONCLUSIONS - CAC density is not associated with mortality independent from CAC volume in European Americans and African Americans with type 2 diabetes.

MeSH Terms (18)

Adult African Continental Ancestry Group Aged Aged, 80 and over Coronary Angiography Coronary Artery Disease Coronary Vessels Diabetes Mellitus, Type 2 European Continental Ancestry Group Female Humans Male Middle Aged Plaque, Atherosclerotic Prognosis Risk Factors United States Vascular Calcification

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