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J Diabetes Complications. 2017 Jul;31(7):1096-1102. doi: 10.1016/j.jdiacomp.2017.03.013. Epub 2017 Mar 31.

Diabetes and male sex are key risk factor correlates of the extent of coronary artery calcification: A Euro-CCAD study.

Author information

1
Department of Public Health and Clinical Medicine, Umeå University and Heart Centre, Umeå, Sweden.
2
Department of Ultrasound, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
3
Department of Radiation Sciences, Biomedical Engineering, Umea University, Umeå, Sweden.
4
Department of Cardiology, Odense University Hospital, Denmark.
5
Department of Cardiology, Odense University Hospital, Denmark; Vejle Hospital, Vejle, Denmark.
6
University Alcala, Hospital Ramon y Cajal, Madrid, Spain.
7
University Hospital Henri Mondor, Creteil, Paris, France.
8
Bethanien Hospital, Frankfurt, Germany.
9
Centre de Recherche & Department of Radiology, Montréal Heart Institute/Université de Montréal, Montréal, QC, Canada.
10
Centre de Recherche & Department of Radiology, Montréal Heart Institute/Université de Montréal, Montréal, QC, Canada; Department of Radiology, Erasmus Medical Center University, Rotterdam, the Netherlands.
11
Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Los Angeles, CA, USA.
12
Department of Public Health and Clinical Medicine, Umeå University and Heart Centre, Umeå, Sweden. Electronic address: michael.henein@umu.se.

Abstract

BACKGROUND AND AIMS:

Although much has been written about the conventional cardiovascular risk factor correlates of the extent of coronary artery calcification (CAC), few studies have been carried out on symptomatic patients. This paper assesses the potential ability of risk factors to associate with an increasing CAC score.

METHODS:

From the European Calcific Coronary Artery Disease (Euro-CCAD) cohort, we retrospectively investigated 6309 symptomatic patients, 62% male, from Denmark, France, Germany, Italy, Spain and the USA. All had conventional cardiovascular risk factor assessment and CT scanning for CAC scoring.

RESULTS:

Among all patients, male sex (OR = 4.85, p<0.001) and diabetes (OR = 2.36, p<0.001) were the most important risk factors of CAC extent, with age, hypertension, dyslipidemia and smoking also showing a relationship. Among patients with CAC, age, diabetes, hypertension and dyslipidemia were associated with an increasing CAC score in males and females, with diabetes being the strongest dichotomous risk factor (p<0.001 for both). These results were echoed in quantile regression, where diabetes was consistently the most important correlate with CAC extent in every quantile in both males and females. To a lesser extent, hypertension and dyslipidemia were also associated in the high CAC quantiles and the low CAC quantiles respectively.

CONCLUSION:

In addition to age and male sex in the total population, diabetes is the most important correlate of CAC extent in both sexes.

KEYWORDS:

Coronary calcification extent; Diabetes; Gender; Hypertension; Risk factors

PMID:
28499962
DOI:
10.1016/j.jdiacomp.2017.03.013
[Indexed for MEDLINE]

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