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Coronary Artery Calcium Score as a Risk Enhancer in Pre-Diabetics


Affiliations
1 Department of Cardiology, Sir Ganga Ram Hospital, Old Rajinder Nagar, Delhi-110060, India
2 Department of Cardiology, Sir Ganga Ram Hospital, New Delhi, India
     

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Introduction: Among all the risk factors for atherosclerosis, diabetes is one that has a direct causal association with it, so it has been a focus in major primary prevention studies. The prediabetic population is considered at the same risk as non-diabetics as per the latest guidelines. By using the Coronary artery calcium score (CACS) which is a predictor of cardiovascular events, in this subset of people authors tried to analyse whether prediabetics can be treated the same as non-diabetics. Methods: Patients undergoing CT coronary angiography with no major epicardial coronary artery obstruction were in-cluded and divided into three subgroups of non-diabetic, pre-diabetic and diabetic. Their CACS were measured and compared for any significance. Results: A total of 300 patients were part of the study with 100 patients in each subgroup. The mean age of the population was 48 years. Lipid profile was significantly deranged in the non-diabetic and pre-diabetic subgroup as they were not on any therapy. CACS was 5.4 ± 37.37, 98.02 ± 300.89, 209.47 ± 277.61 in non-diabetic, pre-diabetic and diabetic subgroups respectively. The CACS was much higher in the pre-diabetic subgroup of people missing statistical significance by only a small margin. Conclusion: From this observational study authors conclude that prediabetics are at much higher risk of adverse cardio-vascular events than non-diabetics and so when it comes to primary prevention therapy, they should not be considered in the same risk category as non-diabetics.

Keywords

Primary prevention; risk modifier; atherosclerosis.
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  • Mach F, Baigent C, Catapano AL, Koskinas KC, Casula M, Badimon L, et al; ESC Scientific Document Group. 2019 ESC/ EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. Eur Heart J.2020;41(1):111-188.

  • Arnett DK, Blumenthal RS, Albert MA, Buroker AB, Goldberger ZD, Hahn EJ, et al. 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.Circulation. 2019;140(11):e596-e646.

  • Vliegenthart R, Oudkerk M, Hofman A, Oei HH, van Dijck W, van Rooij FJ, et al. Coronary calcification improves cardiovascular risk prediction in the elderly. Circulation. 2005;112(4):572-7.

  • Yano Y, O’Donnell CJ, Kuller L, Kavousi M, Erbel R, Ning H, et al. Association of Coronary Artery Calcium Score vs Age With Cardiovascular Risk in Older Adults: An Analysis of Pooled Population-Based Studies. JAMA Cardiol.2017;2(9):986-994.

  • Kavousi M, Desai CS, Ayers C, Blumenthal RS, Budoff MJ, Mahabadi AA, et al. Prevalence and Prognostic Implications of Coronary Artery Calcification in Low-Risk Women: A Meta-analysis. JAMA. 2016;316(20):2126-2134.

  • Raggi P, Callister TQ, Shaw LJ. Progression of coronary artery calcium and risk of first myocardial infarction in patients receiving cholesterol-lowering therapy. Arterioscler Thromb Vasc Biol. 2004;24(7):1272-7.

  • Budoff MJ, Young R, Lopez VA, Kronmal RA, Nasir K, Blumenthal RS, et al. Progression of coronary calcium and incident coronary heart disease events: MESA (Multi-Ethnic Study of Atherosclerosis). J Am Coll Cardiol. 2013;61(12):12319.

  • Budoff MJ, Hokanson JE, Nasir K, Shaw LJ, Kinney GL, Chow D, et al. Progression of coronary artery calcium predicts allcause mortality. JACC Cardiovasc Imaging. 2010;3(12):122936.

  • Cosentino F, Grant PJ, Aboyans V, Bailey CJ, Ceriello A, Delgado V, et al; ESC Scientific Document Group. 2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD. Eur Heart J. 2020;41(2):255-323.

  • Maki KC, Diwadkar-Navsariwala V, Kramer MW. Statin use and risk for type 2 diabetes: what clinicians should know. Postgrad Med. 2018;130(2):166-172.


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  • Coronary Artery Calcium Score as a Risk Enhancer in Pre-Diabetics

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Authors

Vyom Mori
Department of Cardiology, Sir Ganga Ram Hospital, Old Rajinder Nagar, Delhi-110060, India
Arun Mohanty
Department of Cardiology, Sir Ganga Ram Hospital, New Delhi, India
Anurag Yadav
Department of Cardiology, Sir Ganga Ram Hospital, New Delhi, India
Aman Makhija
Department of Cardiology, Sir Ganga Ram Hospital, New Delhi, India
Bhuwanesh Kandpal
Department of Cardiology, Sir Ganga Ram Hospital, New Delhi, India
Arjun Sreekumar
Department of Cardiology, Sir Ganga Ram Hospital, New Delhi, India
J. P. S. Sawhney
Department of Cardiology, Sir Ganga Ram Hospital, New Delhi, India
R. R. Mantri
Department of Cardiology, Sir Ganga Ram Hospital, New Delhi, India

Abstract


Introduction: Among all the risk factors for atherosclerosis, diabetes is one that has a direct causal association with it, so it has been a focus in major primary prevention studies. The prediabetic population is considered at the same risk as non-diabetics as per the latest guidelines. By using the Coronary artery calcium score (CACS) which is a predictor of cardiovascular events, in this subset of people authors tried to analyse whether prediabetics can be treated the same as non-diabetics. Methods: Patients undergoing CT coronary angiography with no major epicardial coronary artery obstruction were in-cluded and divided into three subgroups of non-diabetic, pre-diabetic and diabetic. Their CACS were measured and compared for any significance. Results: A total of 300 patients were part of the study with 100 patients in each subgroup. The mean age of the population was 48 years. Lipid profile was significantly deranged in the non-diabetic and pre-diabetic subgroup as they were not on any therapy. CACS was 5.4 ± 37.37, 98.02 ± 300.89, 209.47 ± 277.61 in non-diabetic, pre-diabetic and diabetic subgroups respectively. The CACS was much higher in the pre-diabetic subgroup of people missing statistical significance by only a small margin. Conclusion: From this observational study authors conclude that prediabetics are at much higher risk of adverse cardio-vascular events than non-diabetics and so when it comes to primary prevention therapy, they should not be considered in the same risk category as non-diabetics.

Keywords


Primary prevention; risk modifier; atherosclerosis.

References