Coronary Artery Calcium Score Compared with Cardio-Ankle Vascular Index in the Prediction of Cardiovascular Events in Asymptomatic Patients with Type 2 Diabetes.
OBJECTIVE
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.
Division of Cardiology, Department of Internal Medicine, Lotung Poh-Ai Hospital.
Sheng-Liang
SL
Chung
Chih-Chieh
CC
Yang
Chao-Chin
CC
Chen
Yu-Cheng
YC
Hsu
Meng-Huan
MH
Lei
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000842:Ankle / Q000098:blood supply; D055109:Ankle Brachial Index; D002118:Calcium / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000175:diagnosis; D016022:Case-Control Studies; D003324:Coronary Artery Disease / Q000150:complications; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000378:metabolism*; D048909:Diabetes Complications / Q000097:blood / Q000175:diagnosis; D003924:Diabetes Mellitus, Type 2 / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D012189:Retrospective Studies; D012307:Risk Factors; D061205:Vascular Calcification / Q000097:blood / Q000000981:diagnostic imaging
D002118:Calcium