Diabetes and Hypertension Consistently Predict the Presence and Extent of Coronary Artery Calcification in Symptomatic Patients: A Systematic Review and Meta-Analysis.
BACKGROUND
The relationship of conventional cardiovascular risk factors (age, gender, ethnicity, diabetes, dyslipidaemia, hypertension, obesity, exercise, and the number of risk factors) to coronary artery calcification (CAC) presence and extent has never before been assessed in a systematic review and meta-analysis.


METHODS
We included only English language studies that assessed at least three conventional risk factors apart from age, gender, and ethnicity, but excluded studies in which all patients had another confirmed condition such as renal disease.


RESULTS
In total, 10 studies, comprising 15,769 patients, were investigated in the systematic review and seven studies, comprising 12,682 patients, were included in the meta-analysis, which demonstrated the importance of diabetes and hypertension as predictors of CAC presence and extent, with age also predicting CAC presence. Male gender, dyslipidaemia, family history of coronary artery disease, obesity, and smoking were overall not predictive of either CAC presence or extent, despite dyslipidaemia being a key risk factor for coronary artery disease (CAD).


CONCLUSIONS
Diabetes and hypertension consistently predict the presence and extent of CAC in symptomatic patients.
Department of Public Health and Clinical Medicine, Umea University and Heart Centre, Umea SE-901-87, Sweden. rachelnicoll25@gmail.com.
Rachel
R
Nicoll
Department of Ultrasound, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China. yingzhaoecho@163.com.
Ying
Y
Zhao
Department of Public Health and Clinical Medicine, Umea University and Heart Centre, Umea SE-901-87, Sweden. pranvera_i86@hotmail.com.
Pranvera
P
Ibrahimi
Department of Medical Biosciences, Umea University, Umea SE-901-87, Sweden. gunilla.olivecrona@medbio.umu.se.
Gunilla
G
Olivecrona
Department of Public Health and Clinical Medicine, Umea University and Heart Centre, Umea SE-901-87, Sweden. michael.henein@umu.se.
Michael
M
Henein
D000368:Aged; D003324:Coronary Artery Disease / Q000453:epidemiology*; D003331:Coronary Vessels / Q000473:pathology; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D061205:Vascular Calcification / Q000453:epidemiology*
coronary calcification; meta-analysis; risk factors; systematic review