Potential implications of coronary artery calcium testing for guiding aspirin use among asymptomatic individuals with diabetes.
OBJECTIVE
It is unclear whether coronary artery calcium (CAC) is effective for risk stratifying patients with diabetes in whom treatment decisions are uncertain.


METHODS
Of 44,052 asymptomatic individuals referred for CAC testing, we studied 2,384 individuals with diabetes. Subjects were followed for a mean of 5.6 ± 2.6 years for the end point of all-cause mortality.


RESULTS
There were 162 deaths (6.8%) in the population. CAC was a strong predictor of mortality across age-groups (age <50, 50-59, ≥60), sex, and risk factor burden (0 vs. ≥1 additional risk factor). In individuals without a clear indication for aspirin per current guidelines, CAC stratified risk, identifying patients above and below the 10% risk threshold of presumed aspirin benefit.


CONCLUSIONS
CAC can help risk stratify individuals with diabetes and may aid in selection of patients who may benefit from therapies such as low-dose aspirin for primary prevention.
Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, Maryland, USA.
Michael Gordon
MG
Silverman
Michael J
MJ
Blaha
Matthew J
MJ
Budoff
Juan J
JJ
Rivera
Paolo
P
Raggi
Leslee J
LJ
Shaw
Daniel
D
Berman
Tracy
T
Callister
John A
JA
Rumberger
Jamal S
JS
Rana
Roger S
RS
Blumenthal
Khurram
K
Nasir
D000328:Adult; D000368:Aged; D001241:Aspirin / Q000627:therapeutic use*; D002114:Calcinosis / Q000175:diagnosis*; D003324:Coronary Artery Disease / Q000175:diagnosis*; D003920:Diabetes Mellitus / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged
D001241:Aspirin