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

Publisher: BioMed Central Country of Publication: England NLM ID: 101147637 Publication Model: Electronic Cited Medium: Internet ISSN: 1475-2840 (Electronic) Linking ISSN: 14752840 NLM ISO Abbreviation: Cardiovasc Diabetol Subsets: MEDLINE

Original Publication: London : BioMed Central, [2002-

Coronary Artery Disease/*mortality ; Diabetes Mellitus, Type 2/*mortality ; Vascular Calcification/*mortality; Adult ; Aged ; Aged, 80 and over ; Black People ; Coronary Angiography ; Coronary Artery Disease/diagnostic imaging ; Coronary Artery Disease/ethnology ; Coronary Vessels/diagnostic imaging ; Diabetes Mellitus, Type 2/diagnosis ; Diabetes Mellitus, Type 2/ethnology ; Female ; Humans ; Male ; Middle Aged ; Plaque, Atherosclerotic ; Prognosis ; Risk Factors ; United States/epidemiology ; Vascular Calcification/diagnostic imaging ; Vascular Calcification/ethnology ; White People ; Black or African American

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.

BMC Med Imaging. 2012 Jul 02;12 :14. (PMID: 22747658)
N Engl J Med. 2008 Mar 27;358(13):1336-45. (PMID: 18367736)
JAMA Cardiol. 2017 Apr 1;2(4):391-399. (PMID: 28196265)
Diabetes Care. 2014 Oct;37(10):2798-803. (PMID: 24989706)
JACC Cardiovasc Imaging. 2017 Aug;10 (8):845-854. (PMID: 28797404)
Am J Epidemiol. 2007 Aug 1;166(3):340-7. (PMID: 17493948)
J Am Coll Cardiol. 1990 Mar 15;15(4):827-32. (PMID: 2407762)
J Am Coll Cardiol. 2010 Oct 19;56(17 ):1397-406. (PMID: 20946997)
Diabetes Care. 2011 May;34(5):1219-24. (PMID: 21398528)
Radiology. 2005 Jan;234(1):35-43. (PMID: 15618373)
Atherosclerosis. 2011 Dec;219(2):616-22. (PMID: 21930271)
J Am Coll Cardiol. 2003 Jan 1;41(1):39-44. (PMID: 12570942)
JACC Cardiovasc Imaging. 2010 Jul;3(7):691-8. (PMID: 20633846)
Circulation. 1995 Oct 15;92 (8):2157-62. (PMID: 7554196)
Invest Radiol. 1997 Sep;32(9):503-6. (PMID: 9291037)
Radiology. 2003 Sep;228(3):826-33. (PMID: 12869688)
Atherosclerosis. 2013 Dec;231(2):198-204. (PMID: 24267226)
Atherosclerosis. 2014 Oct;236(2):411-7. (PMID: 25150939)
AJR Am J Roentgenol. 1996 Aug;167(2):439-44. (PMID: 8686622)
Acta Radiol. 2012 Jul;53(6):643-7. (PMID: 22761343)
JAMA. 2010 Apr 28;303(16):1610-6. (PMID: 20424251)
J Am Coll Cardiol. 2003 Mar 19;41(6):1008-12. (PMID: 12651050)
Cardiovasc Diabetol. 2013 Nov 05;12 :161. (PMID: 24188692)
Circulation. 2014 Jan 21;129(3):e28-e292. (PMID: 24352519)
Circ Cardiovasc Genet. 2013 Feb;6(1):97-105. (PMID: 23233742)
Bone. 2008 Jan;42(1):43-52. (PMID: 17964237)
Circulation. 2005 Mar 15;111(10):1313-20. (PMID: 15769774)
J Clin Epidemiol. 2001 Jan;54(1):40-50. (PMID: 11165467)
Rev Diabet Stud. 2010 Fall;7(3):188-201. (PMID: 21409311)
Diabetologia. 2005 Dec;48(12):2511-8. (PMID: 16261310)
Arterioscler Thromb Vasc Biol. 2015 May;35(5):1271-8. (PMID: 25745061)
Int J Cardiol. 2015 Apr 1;184:581-6. (PMID: 25769003)
JACC Cardiovasc Imaging. 2008 Jan;1(1):61-9. (PMID: 19356407)
Clin Imaging. 2015 Sep-Oct;39(5):799-802. (PMID: 26068098)
JAMA. 2014 Jan 15;311(3):271-8. (PMID: 24247483)
Atherosclerosis. 2015 Mar;239(1):109-17. (PMID: 25585030)
Prev Chronic Dis. 2013 May 09;10:E76. (PMID: 23660118)
BMJ. 2013 Mar 25;346:f1654. (PMID: 23529983)
Radiology. 2008 Jun;247(3):669-75. (PMID: 18413889)
Diabetes Care. 2013 Apr;36(4):972-7. (PMID: 23230101)
AJR Am J Roentgenol. 2000 Apr;174(4):915-21. (PMID: 10749222)
Radiology. 2003 Feb;226(2):483-8. (PMID: 12563143)

R01 HL092301 United States NH NIH HHS; R01 AR048797 United States AR NIAMS NIH HHS; R01 AR48797 United States NH NIH HHS; T32 HL129982 United States HL NHLBI NIH HHS; R01 HL067348 United States HL NHLBI NIH HHS; F31 AG044879 United States AG NIA NIH HHS; R01 HL092301 United States HL NHLBI NIH HHS; R01 HL67348 United States NH NIH HHS

Keywords: Coronary artery calcification; Mortality; Plaque density; Type 2 diabetes

Date Created: 20180513 Date Completed: 20190128 Latest Revision: 20240712

20240712

PMC5946410

10.1186/s12933-018-0714-z

29751802